Thomas Earl Grant Jr., D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

6715760-1202 Issued in UT

Practice address

1390 Mulholland St
Nauvoo, IL 62354-1010

Phone

(172) 250-1800

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nauvoo Health & Chiropractic

  • Sports Physician Chiropractor
  • Nauvoo, IL
  • NPI 1245948520
  NPD Authorized official
• Millcreek Chiropractic LLC

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1447443973
  NPD (past) Authorized official
• Psychological Associates of Central Illinois LTD

  • Psychiatry Physician
  • Springfield, IL
  • NPI 1376698050
  NPD (past)
• Paulk Chiropractic-Fayettevill Inc.

  • Chiropractor
  • Fayetteville, GA
  • NPI 1508900432
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1992769046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 KNIGHT ST",
            "city": "NAUVOO",
            "state": "IL",
            "postal_code": "623542037",
            "telephone_number": "801-376-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 MULHOLLAND ST",
            "city": "NAUVOO",
            "state": "IL",
            "postal_code": "623541010",
            "telephone_number": "172-250-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "THOMAS",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2022-02-14",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "6715760-1202",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "UT",
            "license": "6715760-1202",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "6715760-1202",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "UT",
            "license": "6715760-1202",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "UT",
            "license": "6715760-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanne A Brooks, SSP
• Lauren Carlisle
• Carol Ann Conrad III, EDD
• Luann Haas
• Mattie Ann Haas, PHARMD
• Julie Herbstrith, PH.D.
• Ruth Kelly, PHD
• Memorial Hospital Association

• Rehabilitation Chiropractor in Nauvoo, IL
• Providers in Nauvoo, IL by specialty
• Rehabilitation Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.