Active NPI
Susan Grayson, M.D.
- Psychiatry Physician
- Durango, CO
National Provider Identifier
1003925934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 15782
- Practice address
- 303 Blue Spruce TRL
Durango, CO 81301-6519 - Phone
- (970) 259-0321
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 15782 | OK | Primary |
Addresses
Primary practice location
303 Blue Spruce TRL
Durango, CO 81301-6519
Mailing address
303 Blue Spruce TRL
Durango, CO 81301-6519
Phone (970) 259-0321
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003925934 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62994 | CA | MD | Marriage & Family Therapist |
| 15782 | OK | MD | Medical license number |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476748800000",
"number": "1003925934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 BLUE SPRUCE TRL",
"city": "DURANGO",
"state": "CO",
"postal_code": "813016519",
"telephone_number": "970-259-0321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 BLUE SPRUCE TRL",
"city": "DURANGO",
"state": "CO",
"postal_code": "813016519",
"telephone_number": "970-259-0321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAYSON",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2016-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OK",
"license": "15782",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003925934",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durango, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.