Grapevine Medical LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

1171-01 Issued in CO

Legal business name

GRAPEVINE MEDICAL LLC

Doing business as

MindGenesis

Practice address

991 Southpark Dr
Suite 200
Littleton, CO 80120-5688

Phone

(303) 577-5800

NPI assigned

Oct 19, 2011

Organization subpart

No

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

Authorized official

Name

Margaret Parra

Title

Manager/Member

Phone

(303) 577-5800

Specialties & licenses 1

Addresses

Other names 1

• MindGenesis Doing business as

Locations

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1427333780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 SOUTHPARK DR",
            "address_2": "SUITE 200",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205688",
            "telephone_number": "303-577-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 SOUTHPARK DR",
            "address_2": "SUITE 200",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205688",
            "telephone_number": "303-577-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAPEVINE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "PARRA",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "303-577-5800"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "1171-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MindGenesis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scot C Graham, MD
• Brittney Sheryce Grammer
• Meagan Elizabeth Grandgenett, NP
• Kianna Granlund, PTA
• Wendy L Grant, PT, DPT
• Caela Graumann
• Abigail Graveline
• Rodney Thomas Gravenor, CSA
• Brent Robert Graves, D.C.
• Keith David Graves, D.C.

• Diagnostic Radiology Physician in Littleton, CO
• Providers in Littleton, CO by specialty
• Diagnostic Radiology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.