Individual provider Active NPI

Jennifer Leigh Grise, NP

  • Family Nurse Practitioner
  • North Conway, NH
National Provider Identifier
1578627972
Registry record updated Mar 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
063747-23 Issued in NH
Practice address
3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone
(603) 356-5461
Fax
(603) 356-6475
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2013

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 063747-23 NH Primary

Addresses

Primary practice location

3073 White Mountain Hwy
North Conway, NH 03860-7101

Mailing address

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5461

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
063747-23NHMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362182400000",
    "number": "1578627972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101",
            "telephone_number": "603-356-5461",
            "fax_number": "603-356-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101",
            "telephone_number": "603-356-5461",
            "fax_number": "603-356-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISE",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2013-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "063747-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2013; 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.