NPIMap

Individual provider Active NPI

Shauna Marie Grady, D.O.

  • Internal Medicine Physician
  • Loveland, CO
National Provider Identifier
1164867735
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR0056675 Issued in CO
Practice address
2923 Ginnala Dr
Loveland, CO 80538-2702
Phone
(970) 669-6660
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR0056675 CO Primary

Addresses

Primary practice location

2923 Ginnala Dr
Loveland, CO 80538-2702

Mailing address

2923 Ginnala Dr
Loveland, CO 80538-2702
Phone (970) 669-6660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160707002199 CO Practitioner - Internal Medicine 9638461890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Health Physicians Colorado LLCGroup PAC ID 8921273038, 278 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

2701 Madison Square Dr
Loveland, CO 80538-3386
Phone (970) 820-6660

2964 Ginnala Dr
Loveland, CO 80538-2701
Phone (970) 667-7755

4617 W 20TH St
Unit a Select PT
Greeley, CO 80634-3207
Phone (970) 352-9022

Hospital & facility affiliations

  • Banner Home Care Colorado Home health agency, Greeley, CO, CCN 067147
  • Columbine Poudre Home Care Home health agency, Fort Collins, CO, CCN 067084
  • Bayada Home Health Care Inc Home health agency, Loveland, CO, CCN 067506
  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001
  • Banner North Co Medical Center - Loveland Campus Hospital, Loveland, CO, CCN 060030
  • Banner Fort Collins Medical Center Hospital, Fort Collins, CO, CCN 060126
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DR0056675COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2016 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Aug 1, 2016 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2923 Ginnala Dr
Loveland, CO 80538
Phone (970) 669-6660

2701 Madison Square Dr
Loveland, CO 80538
Phone (970) 663-0722

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 and National Provider Directory roles.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1164867735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 GINNALA DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382702",
            "telephone_number": "970-669-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2923 GINNALA DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382702",
            "telephone_number": "970-669-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "SHAUNA",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR0056675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.