Individual provider Active NPI

Elizabeth Claire Grubb

  • Registered Dietitian
  • Denver, CO
National Provider Identifier
1366079766
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86168612 Issued in CO
Practice address
916 S Williams St
Denver, CO 80209-4543
Phone
(706) 248-5337
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86168612 CO Primary

Addresses

Primary practice location

916 S Williams St
Denver, CO 80209-4543

Mailing address

916 S Williams St
Denver, CO 80209-4543
Phone (706) 248-5337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240521004031 TX Practitioner - Registered Dietitian Or Nutrition Professional 3577905629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cow Creek Band of Umpqua Tribe of IndiansGroup PAC ID 8921099474, 21 clinicians

Practice addresses (Care Compare)

2589 NW Edenbower Blvd
Roseburg, OR 97471-6224
Phone (541) 672-8533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86168612COMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Cow Creek Band of Umpqua Tribe of Indians CurrentSince May 28, 2024 Accepting new patients
Cow Creek Band of Umpqua Tribe of Indians CurrentSince May 28, 2024 Accepting new patients

Organizations & group practices 2

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1366079766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 S WILLIAMS ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094543",
            "telephone_number": "706-248-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 S WILLIAMS ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094543",
            "telephone_number": "706-248-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBB",
        "first_name": "ELIZABETH",
        "middle_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "86168612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.