Active NPI
Celena Grissam, PA-C
- Physician Assistant
- Colorado Springs, CO
National Provider Identifier
1124981618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0009514
- Practice address
- P.O. Box 62473
8585 Criterion Dr.
Colorado Springs, CO 80962 - Phone
- (719) 331-0753
- NPI assigned
- Dec 3, 2025
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0009514 | CO | Primary |
Addresses
Primary practice location
P.O. Box 62473
8585 Criterion Dr.
Colorado Springs, CO 80962
Mailing address
P.O. Box 62473
8585 Criterion Dr.
Colorado Springs, CO 80962
Phone (719) 331-0753
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)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0009514 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Two Medical Group, PLLC | Past | Accepting new patients |
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.
-
- Primary Care Clinic/Center
- Houston, TX
- NPI 1588320964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764720000000",
"number": "1124981618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 62473",
"address_2": "8585 CRITERION DR.",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80962",
"telephone_number": "719-331-0753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "P.O. BOX 62473",
"address_2": "8585 CRITERION DR.",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80962",
"telephone_number": "719-331-0753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISSAM",
"first_name": "CELENA",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-03",
"last_updated": "2025-12-03",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "0009514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.