Individual provider Active NPI

Lance A Grizzard, CRNA

  • Certified Registered Nurse Anesthetist
  • Mechanicsville, VA
National Provider Identifier
1104814516
Registry record updated Jan 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024166429 Issued in VA
Practice address
8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone
(804) 288-6258
Fax
(804) 282-9921
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001154508 VA
Certified Registered Nurse Anesthetist 367500000X 0024166429 VA Primary

Addresses

Primary practice location

8260 Atlee Rd
Mechanicsville, VA 23116-1844

Mailing address

3100 Spring Forest Rd Ste 130
Raleigh, NC 27616-2880
Phone (888) 280-9533

Other identifiers 1

IdentifierTypeStateIssuer
010163188MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050422000986 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446298095 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001154508VAMDRegistered Nurse
0024166429VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Specialists LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 4, 2026 Accepting new patients

Locations

201 Wadsworth Dr
North Chesterfield, VA 23236
Phone (804) 289-1131

215 Wadsworth Dr
North Chesterfield, VA 23236
Phone (804) 497-4973

1600 Wilkes Ridge Dr
Ste 100
Richmond, VA 23233
Phone (703) 563-0042

6602 W Broad St
#B
Richmond, VA 23230
Phone (804) 289-1137

110 N Robinson St
Ste 100
Richmond, VA 23220
Phone (804) 254-5300

2369 Staples Mill Rd
Ste 100
Richmond, VA 23230
Phone (804) 354-8818

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515715200000",
    "number": "1104814516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD STE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "888-280-9533",
            "fax_number": "919-873-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 ATLEE RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161844",
            "telephone_number": "804-288-6258",
            "fax_number": "804-282-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIZZARD",
        "first_name": "LANCE",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2018-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001154508",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024166429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010163188",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; 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.