Active NPI
Donovan Lee Grierson, PA
- Physician Assistant
- Scottsdale, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 8417
- Practice address
- 13400 E Shea Blvd
Scottsdale, AZ 85259-5499 - Phone
- (480) 301-8000
- NPI assigned
- Dec 7, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 8417 | AZ | Primary |
| Medical Physician Assistant | 363AM0700X |
Addresses
Primary practice location
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Mailing address
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000
Other practice location 1
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8417 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Hospital Based Physicians Arizona LLC | Current | Accepting new patients | |
| Banner Hospital Based Physicians Arizona LLC | Current | Accepting new patients | |
| Banner Cancer Center Specialists LLC | Current | Accepting new patients |
Locations
1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000
2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523
2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450
6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000
807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222
1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JAEEBA/Endpoint/JAEEBA
Organizations & group practices 7
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.
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-
- Multi-Specialty Clinic/Center
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- NPI 1275889891
-
- Emergency Medicine Physician
- Mesa, AZ
- NPI 1912053752
-
- Emergency Medicine Physician
- Pleasanton, CA
- NPI 1821391269
AZ
-
- Oncology Clinic/Center
- Payson, AZ
- NPI 1588158448
-
- Multi-Specialty Clinic/Center
- Gilbert, AZ
- NPI 1124374822
-
- Critical Care Medicine (Internal Medicine) Physician
- Phoenix, AZ
- NPI 1780445171
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634601600000",
"number": "1154836526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13400 E SHEA BLVD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852595499",
"telephone_number": "480-301-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13400 E SHEA BLVD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852595499",
"telephone_number": "480-301-8000"
}
],
"practiceLocations": [
{
"address_1": "1638 Owen Dr",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "283043424",
"country_code": "US",
"telephone_number": "910-615-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRIERSON",
"first_name": "DONOVAN",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-07",
"last_updated": "2021-10-19",
"certification_date": "2021-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "8417",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.