Petra Grinnell, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

550234 Issued in TX

Practice address

1303 McCullough Ave
Suite 374
San Antonio, TX 78212-5615

Phone

(210) 223-5483

Fax

(210) 223-5492

NPI assigned

Aug 17, 2010

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1181

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.

• Endocrinology Nuclear Medicine Associates PA

  • Endocrinology, Diabetes & Metabolism Physician
  • San Antonio, TX
  • NPI 1366581589
  Medicare reassignment NPD

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1386959120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE",
            "address_2": "SUITE 374",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125615",
            "telephone_number": "210-223-5483",
            "fax_number": "210-223-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE",
            "address_2": "SUITE 374",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125615",
            "telephone_number": "210-223-5483",
            "fax_number": "210-223-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINNELL",
        "first_name": "PETRA",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "550234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Jean Grimm, O.D.
• Steven Wayne Grimm, D.C.
• Cheryllann Grimsley, LPC
• Dezabre Grimsley
• Rachel Grinnan, DO
• Ralph Eugene Grinnell Jr., APRN, FNP-BC
• Andrew Grissom
• Rebecca Grissom
• Grit & Grace Counseling, PLLC
• Matthew Gritis, CRNA

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.