Michael B Grillot, M.D.

Primary specialty

Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X

License

106801 Issued in MO

Practice address

1906 Blake Ave
Glenwood SPGS, CO 81601-4227

Phone

(970) 384-7140

Fax

(970) 384-7293

NPI assigned

Nov 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1366423980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 BLAKE AVE",
            "city": "GLENWOOD SPGS",
            "state": "CO",
            "postal_code": "816014227",
            "telephone_number": "970-384-7140",
            "fax_number": "970-384-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BLAKE AVE",
            "city": "GLENWOOD SPGS",
            "state": "CO",
            "postal_code": "816014227",
            "telephone_number": "970-384-7140",
            "fax_number": "970-384-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLOT",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "MO",
            "license": "106801",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CO",
            "license": "54940",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128583001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RR",
            "identifier": "P01085134",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366423980",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wade M Ceola, M.D.
• Karen Church, RPT
• Kathleen Ann Feinsinger, NP
• Leslie E Fuller, DO
• Glenwood Springs Anesthesiologists PC
• Brooke M Halliwell, DO
• George F Holmes, MD
• Karen Church Physical Therapy P C
• Suresh Khilnani, MD
• Robert M Macaulay, MD

• Orthopaedic Hand Surgery Physician in Glenwood SPGS, CO
• Providers in Glenwood SPGS, CO by specialty
• Orthopaedic Hand Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.