Individual provider Active NPI

Kathryn Tish Grifo

  • Family Nurse Practitioner
  • Watsonville, CA
National Provider Identifier
1245560747
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21414 Issued in CA
Practice address
40 Penny LN
Watsonville, CA 95076-6008
Phone
(831) 768-0412
NPI assigned
Jan 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9209384 FL
Family Nurse Practitioner 363LF0000X 21414 CA Primary

Addresses

Primary practice location

40 Penny LN
Watsonville, CA 95076-6008

Mailing address

40 Penny LN
Watsonville, CA 95076-6008

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

State licenses

LicenseStateTypeSpecialty
ARNP9209384FLMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: kathryn.grifo.1@14789.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1245560747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PENNY LN",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950766008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PENNY LN",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950766008",
            "telephone_number": "831-768-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFO",
        "first_name": "KATHRYN",
        "middle_name": "TISH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9209384",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.