Individual provider Active NPI

David Manson Grisham, NP-C

  • Family Nurse Practitioner
  • Madison, AL
National Provider Identifier
1487042800
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-097187 Issued in AL
Practice address
8375 Highway 72 W
Madison, AL 35758-9573
Phone
(256) 265-2012
NPI assigned
Jan 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-097187 AL Primary

Addresses

Primary practice location

8375 Highway 72 W
Madison, AL 35758-9573

Mailing address

8375 Highway 72 W
Madison, AL 35758-9573
Phone (256) 265-2012

Other practice location 1

2908 Mall Rd
Florence, AL 35630-1641
Phone (256) 767-2702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20150701001987 AL Practitioner - Nurse Practitioner 2365754421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Plus IncGroup PAC ID 7911924931, 5 clinicians

Practice addresses (Care Compare)

2908 Mall Rd
Florence, AL 35630-1534
Phone (256) 767-2702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-097187ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Athens-Limestone ER Physicians CurrentSince Apr 19, 2015 Accepting new patients
Med Plus, Inc CurrentSince Jun 12, 2023 Accepting new patients

Locations

700 W Market St
Athens, AL 35611
Phone (256) 233-9292

2908 Mall Rd
Florence, AL 35630
Phone (256) 767-2702

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1487042800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8375 HIGHWAY 72 W",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357589573",
            "telephone_number": "256-265-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8375 HIGHWAY 72 W",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357589573",
            "telephone_number": "256-265-2012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2908 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AL",
            "postal_code": "356301641",
            "country_code": "US",
            "telephone_number": "256-767-2702",
            "fax_number": "256-712-6275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "DAVID",
        "middle_name": "MANSON",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-07",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-097187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.