Kelly Holley Grillo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

J0509 Issued in TX

Practice address

700 Scott and White Dr
College Station, TX 77845-6441

Phone

(979) 207-0100

Fax

(979) 207-2161

NPI assigned

Jul 29, 2006

Last updated

Sep 12, 2019By 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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kgrillo24112@direct.sw.org

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• College Station III Enterprises, LLC

  dba Five Points Nursing & Rehabilitation of College Station

  • Skilled Nursing Facility
  • College Station, TX
  • NPI 1790546505

  Adp of the SNF

  CMS ownership
• Fannin County Hospital Authority

  dba Avir at Hearne

  • Skilled Nursing Facility
  • Hearne, TX
  • NPI 1295568525

  Adp of the SNF

  CMS ownership

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.

• CH Specialty Services TX PLLC

  • Family Nurse Practitioner
  • Austin, TX
  • NPI 1306225701

  Internal Medicine

  Medicare reassignment NPD
• Curana Health Medical Group LLC

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1255640678
  Medicare reassignment NPD
• College Station I Enterprises, L.L.C.

  dba Fortress Nursing and Rehabilitation

  • Skilled Nursing Facility
  • College Station, TX
  • NPI 1063054823
  NPD (past)
• College Station II Enterprises, LLC

  dba Lampstand Nursing and Rehabilitation

  • Skilled Nursing Facility
  • Bryan, TX
  • NPI 1295377067
  NPD (past)
• College Station III Enterprises, LLC

  dba Five Points Nursing & Rehabilitation of College Station

  • Skilled Nursing Facility
  • College Station, TX
  • NPI 1790546505
  NPD (past)
• Fannin County Hospital Authority

  dba Avir at Hearne

  • Skilled Nursing Facility
  • Hearne, TX
  • NPI 1295568525
  NPD (past)
• Hearne I Enterprises, LLC

  dba Crossroads Nursing & Rehabilitation

  • Skilled Nursing Facility
  • Hearne, TX
  • NPI 1871996363
  NPD (past)

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1306851274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SCOTT AND WHITE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456441",
            "telephone_number": "979-207-0100",
            "fax_number": "979-207-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "KELLY",
        "middle_name": "HOLLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J0509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew T Greene, OD
• Sean D Gregorio, BS,RBT
• Kathryn Greiner, M.D.
• Karen J Griffin, CRNA
• Myra Vanessa Grijalva
• Shelby Grimes
• Linda E M Grismer, MD
• Brandee Grissett, LPC
• Katherine Groezinger, OTD, OTR/L
• Grow Forward Counseling PLLC

• Internal Medicine Physician in College Station, TX
• Providers in College Station, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.