Chiropractic Health Clinic of Brevard PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH 8328 FL Issued in FL

Legal business name

CHIROPRACTIC HEALTH CLINIC OF BREVARD PA

Practice address

110 N Tropical TRL
Merritt Island, FL 32953-4737

Phone

(321) 459-9400

NPI assigned

Jul 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Paul Vincent Grimm, D.C.NPI 1639215007

Title

President

Phone

(321) 459-9400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Vincent Grimm, D.C.

  • Chiropractor
  • Merritt Island, FL
  • NPI 1639215007
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1992995757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N TROPICAL TRL",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N TROPICAL TRL",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534737",
            "telephone_number": "321-459-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC HEALTH CLINIC OF BREVARD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-459-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 8328 FL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "K5848",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phyllis Chang
• Brianna Cheatham
• Jennifer Chebro, LCSW
• Jill Renee Cheney, RN
• Munyaradzi Warren Chinyanganya
• Choices Behavioral Health LLC
• Bindi Gautam Chokshi, MD
• Kelly Chong, DDS
• Connie Christensen, MS CCC SLP
• Christopher Management, Inc.

• All providers in Merritt Island, FL
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.