Individual provider Active NPI

Scott Grigg, APN

  • Neonatal Nurse Practitioner
  • Springdale, AR
National Provider Identifier
1023240744
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AO1678 Issued in AR
Practice address
4301 Greathouse Springs Rd
Springdale, AR 72762-8701
Phone
(479) 684-3132
Fax
(479) 684-3098
NPI assigned
Aug 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X R62819 AR
Neonatal Nurse Practitioner 363LN0000X AO1678 AR Primary

Addresses

Primary practice location

4301 Greathouse Springs Rd
Springdale, AR 72762-8701

Mailing address

4301 Greathouse Springs Rd
Springdale, AR 72762-8701
Phone (479) 684-3132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091201000165 AR Practitioner - Nurse Practitioner 2769521921 Reassigns benefits to 1 organization
I20150521002584 MO Practitioner - Nurse Practitioner 2769521921 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AO1678ARMDNeonatal Nurse Practitioner
R62819ARMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Springdale- Bentonville HBP Services, LLC Neonatal CurrentSince Jan 20, 2024 Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

4301 Willow Creek Dr
Springdale, AR 72762
Phone (479) 684-3104

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1023240744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 GREATHOUSE SPRINGS RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727628701",
            "telephone_number": "479-684-3132",
            "fax_number": "479-684-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GREATHOUSE SPRINGS RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727628701",
            "telephone_number": "479-684-3132",
            "fax_number": "479-684-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGG",
        "first_name": "SCOTT",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-13",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AR",
            "license": "R62819",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AR",
            "license": "AO1678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.