Christopher Mark Grussendorf, MD, MPH

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

0101229870 Issued in VA

Practice address

Randolph AFB MTF
221 Third Street West, BLDG 1040
Jbsa, Randolph, TX 78150

Phone

(210) 652-8544

NPI assigned

Sep 23, 2005

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1437145570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RANDOLPH AFB MTF",
            "address_2": "221 THIRD STREET WEST, BLDG 1040",
            "city": "JBSA, RANDOLPH",
            "state": "TX",
            "postal_code": "78150",
            "telephone_number": "210-652-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RANDOLPH AFB MTF",
            "address_2": "221 THIRD STREET WEST, BLDG 1040",
            "city": "JBSA, RANDOLPH",
            "state": "TX",
            "postal_code": "78150",
            "telephone_number": "210-652-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSSENDORF",
        "first_name": "CHRISTOPHER",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "VA",
            "license": "0101229870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Jane Gilbert, MSW
• Michelle Gonzales, PHD, WHNP-BC
• Megan Jenifer Graff, D.M.D.
• Kevin Graham
• Ian David Gregory, D.O.
• Jacqueline Gutierrez, MD
• Gloria J Heater, PA-C
• Jessica Audrey Hess, DDS
• Juliet Rae Hoffman, DDS
• Curtis House, PA-C

• Occupational Medicine Physician in Jbsa Randolph, TX
• Providers in Jbsa Randolph, TX by specialty
• Occupational Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.