Individual provider Active NPI

Kristen E Gricus, PMHNP-BC, IBCLC

  • Psychiatric/Mental Health Nurse Practitioner
  • South Kingstown, RI
National Provider Identifier
1598066615
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN04914 Issued in RI
Practice address
65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569
Phone
(844) 754-6564
NPI assigned
Nov 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN04914 RI Primary

Addresses

Primary practice location

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569

Mailing address

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20260127001993 RI Practitioner - Nurse Practitioner 7315424884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN04914RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. CurrentSince Dec 21, 2025 Accepting new patients

Locations

65 Village Square Dr
Ste 302
South Kingstown, RI 02879
Phone (844) 754-6564

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

Organizations & group practices 1

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": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1598066615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 VILLAGE SQUARE DR STE 302",
            "city": "SOUTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028792569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 VILLAGE SQUARE DR STE 302",
            "city": "SOUTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028792569",
            "telephone_number": "844-754-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRICUS",
        "first_name": "KRISTEN",
        "middle_name": "E",
        "credential": "PMHNP-BC, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN04914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Kingstown, RI

Sources for this page

Verify at the official NPI Registry.