Kelli Grisham

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95032540 Issued in CA

Practice address

6608 Mercy CT Ste B
Fair Oaks, CA 95628-3171

Phone

(916) 241-9844

NPI assigned

Oct 14, 2024

Last updated

Sep 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 CA

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

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.

• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Mariposa, CA
  • NPI 1891207684
  NPD (past)

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1427878420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6608 MERCY CT STE B",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283171",
            "telephone_number": "916-241-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6608 MERCY CT STE B",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283171",
            "telephone_number": "916-241-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "KELLI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95032540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Gray, DC
• Kellen R Grayson, PSY.D. LMFT
• Danielle Kathleen Rounds Greenspan
• Jennifer Hastings Griffith, LMFT
• Gregory Charles Grimes, MASTER
• Ivan Antonio Guerrero Sr., RADT
• Samantha Guerrero
• Esther Siyuan Guo, EMT-B
• Amreen Guru
• Silvia Gutierres

• Primary Care Nurse Practitioner in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.