Mark Gripp

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MED-PHYS-LIC-114091 Issued in MT

Practice address

711 Kapiolani Blvd Ste 200
Honolulu, HI 96813-6028

Phone

(403) 594-1883

NPI assigned

Aug 22, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Proscan NCH Imaging LLC

  • Diagnostic Radiology Physician
  • Naples, FL
  • NPI 1003406711
  Medicare reassignment NPD

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1104544501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46-157 NAHIKU PL",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443625",
            "telephone_number": "403-594-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 KAPIOLANI BLVD STE 200",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968136028",
            "telephone_number": "403-594-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIPP",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MT",
            "license": "MED-PHYS-LIC-114091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Griffiths, RN
• Chelsey Lauren Grimm, BSN, RN
• Gary Grimm
• Lisa M. Grininger, MD
• Nile Kealoha Grinpas, APRN
• Alissa Grischuk, PT
• Julianne Griswold, D.O.
• James Lester Grobe, MD
• Evan M Grosjean, MD
• Maya Maya Grossmann, DNAP, CRNA

• Diagnostic Radiology Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Diagnostic Radiology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.