Kelli Ann Grambeau, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

60645 Issued in ID

Practice address

110 E Wallace Ave
Coeur D Alene, ID 83814-2948

Phone

(208) 853-0707

NPI assigned

May 12, 2020

Last updated

May 12, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Coeur Vitality PLLCGroup PAC ID 2365860343, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: coeurvitalitypllc.kelligrambeau@146182.advancedmd-direct.com

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.

• Coeur Vitality PLLC

  • Clinic/Center
  • Coeur d'Alene, ID
  • NPI 1316574700
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur d'Alene, ID
  • NPI 1992798409
  Care Compare affiliation

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1306468483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 S 11TH ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143805",
            "telephone_number": "904-307-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E WALLACE AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142948",
            "telephone_number": "208-853-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMBEAU",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "60645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "address_1": "110 E Wallace Ave",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter Gordon Gourley, ARNP
• Grace Ridge Counseling
• Kelly Grace, LMP
• Nicholas Graham
• Jose Grajo
• Bruce John Grandstaff Sr., DC
• Alison Marie Granier, M.D.
• Marc Olav Granrud
• Taryn Michelle Grattic, PA
• Luke Jonathan Grauke, MD

• Family Nurse Practitioner in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.