Individual provider Active NPI

Kristin Grilli, OTD

  • Pediatric Occupational Therapist
  • Scottsdale, AZ
National Provider Identifier
1356529234
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
4257 Issued in AZ
Practice address
11572 E Cottontail LN
Scottsdale, AZ 85255-5782
Phone
(480) 788-4543
NPI assigned
Feb 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1352 NE
Pediatric Occupational Therapist 225XP0200X 4257 AZ Primary

Addresses

Primary practice location

11572 E Cottontail LN
Scottsdale, AZ 85255-5782

Mailing address

11572 E Cottontail LN
Scottsdale, AZ 85255-5782
Phone (480) 788-4543

Other identifiers 1

IdentifierTypeStateIssuer
47065477702MedicaidNE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4257AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare3, Inc. PastSince Mar 13, 2006 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1356529234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11572 E COTTONTAIL LN",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555782",
            "telephone_number": "480-788-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11572 E COTTONTAIL LN",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555782",
            "telephone_number": "480-788-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLI",
        "first_name": "KRISTIN",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "1352",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "4257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065477702",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.