Individual provider Active NPI

Kendra Janel Grubb, M.D.

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1265688006
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
79606 Issued in GA
Practice address
550 Peachtree St NE FL 6
Atlanta, GA 30308-2212
Phone
(404) 686-2513
Fax
(404) 686-4959
NPI assigned
Aug 12, 2008
Last updated
Feb 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036120433 IL
Surgery Physician 208600000X 79606 GA Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 45160 KY

Addresses

Primary practice location

550 Peachtree St NE FL 6
Atlanta, GA 30308-2212

Mailing address

550 Peachtree St NE FL 6
Atlanta, GA 30308-2212
Phone (404) 686-2513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180629002466 GA Practitioner - Thoracic Surgery 3173787025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79606GAMDSurgery Physician
036120433ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Surgery Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Mar 1, 2018 Accepting new patients
The Emory Clinic Inc CurrentSince Mar 1, 2018 Accepting new patients
Emory Medical Care Foundation Surgery CurrentSince Mar 1, 2018 Accepting new patients
Emory Health Care Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

550 Peachtree St NE
Fl 6
Atlanta, GA 30308
Phone (404) 686-2513

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: kgrubb19868@direct.emory.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1265688006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE FL 6",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082212",
            "telephone_number": "404-686-2513",
            "fax_number": "404-686-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE FL 6",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082212",
            "telephone_number": "404-686-2513",
            "fax_number": "404-686-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBB",
        "first_name": "KENDRA",
        "middle_name": "JANEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036120433",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "79606",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KY",
            "license": "45160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.