Kenisha Quiana Grandison, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209015880 Issued in IL

Practice address

5841 S Maryland Ave # Mc2115
Chicago, IL 60637-1447

Phone

(773) 834-0475

Fax

(773) 753-4525

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kallenrn15879@uchospital.direct-ci.com

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.

• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• The University of Chicago Medical Center

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1285161075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC2115",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-834-0475",
            "fax_number": "773-753-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC2115",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-834-0475",
            "fax_number": "773-753-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDISON",
        "first_name": "KENISHA",
        "middle_name": "QUIANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine M Grandi
• Debora M Grandinetti, M.D.
• Philip G Grandinetti, M.D.
• Samuel Grandinetti, DDS
• Vickie Julie Grandinetti, D.D.S.
• Ronni Grandison, LMT
• Grandview Health Partners, LTD.
• Lauren Graner
• Joy M Grange
• Anthony Granger

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.