Grigoriy Rodonaia MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

M6986 Issued in TX

Legal business name

GRIGORIY RODONAIA MD PA

Practice address

2955 Harrison St
Ste 200
Beaumont, TX 77702-1154

Phone

(409) 923-1617

Fax

(409) 923-1618

NPI assigned

Jan 16, 2009

Organization subpart

No

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

Authorized official

Name

Grigoriy T Rodonaia, MD

Title

Doctor/Owner

Phone

(409) 923-1617

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rodonaia Family Medicine and Aesthetics Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell N McDonald, D.O.

  • Family Medicine Physician
  • Groves, TX
  • NPI 1669451266
  NPD (past)
• Melissa Katie Thompson, APRN

  • Family Nurse Practitioner
  • Beaumont, TX
  • NPI 1154831816
  NPD (past)

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1497992127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 HARRISON ST",
            "address_2": "STE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021154",
            "telephone_number": "409-923-1617",
            "fax_number": "409-923-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 HARRISON ST",
            "address_2": "STE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021154",
            "telephone_number": "409-923-1617",
            "fax_number": "409-923-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIGORIY RODONAIA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "RODONAIA",
        "authorized_official_first_name": "GRIGORIY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "409-923-1617",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "M6986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0048SA",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rodonaia Family Medicine and Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vicki L Greenwell, MPT
• Gordon Scott Greer
• Shana Levine Gregory, R.PH
• Christy Phelan Greig, AU.D.
• Dennis Joseph Griffiths, FNP-C
• Cindy Kaye Grimes, MS CCC/SLP
• Jaimie Paulette Grimes, FNP
• Troy Toliver Grimes, ATP
• Edward Brown Gripon, M.D.
• Group Care Home Health, LP

• Primary Care Clinic/Center in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.