Michael Grillon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101055534 Issued in VA

Practice address

20486 Market Street
Onancock, VA 23417

Phone

(757) 302-2700

Fax

(757) 787-9262

NPI assigned

Jul 18, 2005

Last updated

Nov 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1205130911

  DC

  Medicare reassignment NPD
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Conyers, GA
  • NPI 1598061293
  NPD
• Bon Secours Memorial Regional Medical Center

  dba Richmond Diabetes and Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Mechanicsville, VA
  • NPI 1225263940
  NPD (past)
• Bon Secours Memorial Regional Medical Center Inc

  dba Bon Secours Surgical Specialists at Memorial Regional Medical Center

  • Surgery Physician
  • Mechanicsville, VA
  • NPI 1477784940
  NPD (past)
• Bon Secours Memorial Regional Medical Center Inc

  dba MRMC Inpatient Surgical Specialists

  • Surgery Physician
  • Mechanicsville, VA
  • NPI 1609186741
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1639178122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8262 ATLEE RD",
            "address_2": "SUITE 205",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161816",
            "telephone_number": "804-559-0194",
            "fax_number": "804-559-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20486 MARKET STREET",
            "city": "ONANCOCK",
            "state": "VA",
            "postal_code": "23417",
            "telephone_number": "757-302-2700",
            "fax_number": "757-787-9262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8262 Atlee Rd",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Mechanicsville",
            "state": "VA",
            "postal_code": "231161816",
            "country_code": "US",
            "telephone_number": "804-559-0194",
            "fax_number": "804-559-0198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRILLON",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101055534",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101055534",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1373138",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "020002600",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET-WV COMP",
            "identifier": "1073988",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790577T",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810012912",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639178122",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2132448",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "178223",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5472512",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06115",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern Shore Rural Health System Incorporated.
• F.C. of Virginia, Inc. (Intrepid USA Healthcare Services)
• Fletcher Drummond Fosque, DDS
• Jeremy Grant, M.D.
• Jacob Seth Greenberg, DO
• Thomas Fisher Hare, RPA-C
• Crystal Harris, MSN, AGACNP C
• Deborah A. Heffron, RD, LDN
• Emory F Hurst Jr., RPH
• Robert Ingram, M.D.

• Family Medicine Physician in Onancock, VA
• Providers in Onancock, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.