NPIMap

Individual provider Active NPI

Kenneth Grigsby, MD

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1417983792
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
11862 Issued in NV
Practice address
2450 W Charleston Blvd
Las Vegas, NV 89102-2179
Phone
(702) 877-8660
Fax
(702) 877-5140
NPI assigned
Jun 25, 2006
Last updated
Feb 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 11862 NV Primary

Addresses

Primary practice location

2450 W Charleston Blvd
Las Vegas, NV 89102-2179

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (702) 877-8661

Other practice location 1

1800 W Charleston Blvd
Las Vegas, NV 89102-2386
Phone (702) 383-2000

Other identifiers 10

IdentifierTypeStateIssuer
1417983792OtherCAMEDI-CAL
1417983792MedicaidWA
1417983792MedicaidNV
168644001MedicaidAR
192828MedicaidAZ
100510148MedicaidNV
1770556037MedicaidUT
8480675MedicaidWA
63334526MedicaidCO
P00618862OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070111000229 NV Practitioner - Anesthesiology 6800896010 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nevada School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red Rock Anesthesia Consultants LLCGroup PAC ID 4284910290, 109 clinicians

Practice addresses (Care Compare)

1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2000

5400 S Rainbow Blvd
Las Vegas, NV 89118-1859
Phone (702) 325-4651

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11862NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Group Rhodes P C CurrentSince Dec 1, 2019 Accepting new patients
Optum Medical Group Rhodes P C CurrentSince Dec 1, 2019 Accepting new patients
Red Rock Anesthesia Consultants LLC Anesthesiology CurrentSince Dec 29, 2022 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Mar 15, 2026 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Mar 15, 2026 Accepting new patients
Optum Medical Group Rhodes P C Anesthesiology Current Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Aug 7, 2006 Accepting new patients

Locations

58 N Pecos Rd
Henderson, NV 89074
Phone (702) 822-2000

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

2450 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8660

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

Interoperability endpoints

  • Direct secure messaging: kgrigsby13091@direct.umcsn.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1417983792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-877-8661",
            "fax_number": "702-877-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022179",
            "telephone_number": "702-877-8660",
            "fax_number": "702-877-5140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022386",
            "country_code": "US",
            "telephone_number": "702-383-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIGSBY",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "11862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "1417983792",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417983792",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417983792",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168644001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192828",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510148",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770556037",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8480675",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63334526",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00618862",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.