Dannetta Grisham, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C7699 Issued in AR

Practice address

300 Werner St
Hot Springs, AR 71913-6406

Phone

(501) 622-1120

Fax

(501) 622-1199

NPI assigned

Apr 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Petite Roche Emergency Physicians

  • Emergency Medicine Physician
  • Little Rock, AR
  • NPI 1861504409
  NPD (past)
• St Edward Medical Services, Inc.

  • Primary Care Clinic/Center
  • Van Buren, AR
  • NPI 1588878466
  NPD (past)

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1013974468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241035",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722230001",
            "telephone_number": "501-258-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WERNER ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136406",
            "telephone_number": "501-622-1120",
            "fax_number": "501-622-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "DANNETTA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C7699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LINKED",
            "identifier": "539876972",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117633001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James E Griffin, MD
• Johnita Griffith, RBT
• Whitney Marie Griffith, APRN-CNP
• Anthony David Grimm, APRN
• Larry L Grinder, DC
• Luke Ryan Grisham, DO
• Andrew James Grose, MD
• Meredith Rose Grubbs, DPT
• Patsy A Guin, RN
• Janice J Gunnels, M.D.

• Emergency Medicine Physician in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.