Individual provider Active NPI

Diana Marie Grushan, RN

  • Ambulatory Women's Health Care Registered Nurse
  • Boulder, CO
National Provider Identifier
1366858136
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X
License
0060277 Issued in CO
Practice address
2855 Valmont Rd
Boulder, CO 80301-1309
Phone
(303) 442-5160
Fax
(303) 440-8769
NPI assigned
Jul 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 0060277 CO Primary

Addresses

Primary practice location

2855 Valmont Rd
Boulder, CO 80301-1309

Mailing address

2886 La Grange Cir
Boulder, CO 80305-6339
Phone (720) 252-2149

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0060277COMDAmbulatory Women's Health Care Registered Nurse

Interoperability endpoints

  • Direct secure messaging: diana.grushan.p36@direct.ipn.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1366858136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2886 LA GRANGE CIR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056339",
            "telephone_number": "720-252-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 VALMONT RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011309",
            "telephone_number": "303-442-5160",
            "fax_number": "303-440-8769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSHAN",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CO",
            "license": "0060277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.