Active NPI
Kirstin F Grahn, MD
- Pediatrics Physician
- Nogales, AZ
National Provider Identifier
1548218571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35453
- Practice address
- 1852 N Mastick Way
Nogales, AZ 85621-1063 - Phone
- (520) 281-1550
- Fax
- (520) 281-1112
- NPI assigned
- May 4, 2006
- Last updated
- Nov 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35453 | AZ | Primary |
Addresses
Primary practice location
1852 N Mastick Way
Nogales, AZ 85621-1063
Mailing address
425 Camino Canoa
Rio Rico, AZ 85648-3724
Phone (520) 281-5648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102080 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nebraska Methodist Hospital | Past | Accepting new patients | |
| Alegent Health Bergan Mercy Health System | Past | Accepting new patients | |
| Children's Physicians | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- kgrahn4873@direct.chsomaha.org
Organizations & group practices 3
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.
-
dba CHI Health Creighton University Medical Center-Bergan Mercy
- General Acute Care Hospital
- Omaha, NE
- NPI 1508941097
-
- Pediatrics Physician
- Omaha, NE
- NPI 1750443503
-
dba Methodist Hospital
- General Acute Care Hospital
- Omaha, NE
- NPI 1427147883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1548218571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 CAMINO CANOA",
"city": "RIO RICO",
"state": "AZ",
"postal_code": "856483724",
"telephone_number": "520-281-5648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1852 N MASTICK WAY",
"city": "NOGALES",
"state": "AZ",
"postal_code": "856211063",
"telephone_number": "520-281-1550",
"fax_number": "520-281-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHN",
"first_name": "KIRSTIN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "35453",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102080",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nogales, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.