Individual provider Active NPI

Chris Grevengood, M.D

  • Obstetrics & Gynecology Physician
  • Bonita Springs, FL
National Provider Identifier
1225087273
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME0067027 Issued in FL
Practice address
9400 Bonita Beach Rd SE Ste 204
Bonita Springs, FL 34135-4520
Phone
(239) 571-9765
Fax
(800) 581-0276
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X ME0067027 FL
Obstetrics & Gynecology Physician 207V00000X ME0067027 FL Primary

Addresses

Primary practice location

9400 Bonita Beach Rd SE Ste 204
Bonita Springs, FL 34135-4520

Mailing address

PO Box 3123
St Augustine, FL 32085-3123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050218000180 FL Practitioner - Obstetrics/Gynecology 1254383375 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB Hospitalist Group LLCGroup PAC ID 5193866838, 127 clinicians

Practice addresses (Care Compare)

11750 Bird Rd
Miami, FL 33175-3530
Phone (864) 908-3530

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0067027FLMDPh.D. Medical Genetics

Practice roles

OrganizationSpecialtyStatusNew patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Feb 20, 2020 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Feb 20, 2020 Accepting new patients
Jorge a Fernandez-Sanchez, MD, PA CurrentSince Jun 14, 2024 Accepting new patients
OBGYN Comprehensive Care, P.a. Obstetrics & Gynecology CurrentSince Sep 19, 2020 Accepting new patients
C Grevengood MD PA Obstetrics & Gynecology PastSince Jan 7, 1999 Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

7100 W 20th Ave
Ste 803
Hialeah, FL 33016
Phone (305) 556-3122

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

6701 Sunset Dr
Ste 109
South Miami, FL 33143
Phone (305) 763-8768

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1225087273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 BONITA BEACH RD SE STE 204",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354520",
            "telephone_number": "239-571-9765",
            "fax_number": "800-581-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREVENGOOD",
        "first_name": "CHRIS",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "FL",
            "license": "ME0067027",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME0067027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.