Samuel Grissom, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME61914 Issued in FL

Practice address

8391 N Davis Hwy
Pensacola, FL 32514

Phone

(850) 494-6000

Fax

(866) 947-4181

NPI assigned

Oct 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ms Methodist Hospital & Rehabilitation Center

  dba Methodist Rehab Ceter

  • Clinical Neuropsychologist
  • Jackson, MS
  • NPI 1285772293
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1205824265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8391 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146048",
            "telephone_number": "850-494-6000",
            "fax_number": "866-947-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8391 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32514",
            "telephone_number": "850-494-6000",
            "fax_number": "866-947-4181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342393509",
            "country_code": "US",
            "telephone_number": "941-917-6574",
            "fax_number": "941-917-4278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "MS",
            "license": "19219",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MS",
            "license": "19219",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME61914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2554707",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan Richard Grimm, MD
• Nikkol Ferris Grinnell, APRN
• Mark Andrew Grise, MD
• Victoria LC Grise, ARNP
• Ruth Anne Grissom, MD
• Desirea Rose Grochola, HAS
• Elliot Groff, DO
• Jason Gronert, MD
• Kevin N Groom, PHD
• Pashia D Groom, PHD

• Physical Medicine & Rehabilitation Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.