Individual provider Active NPI

Dawn M Grinenko, MD

  • Internal Medicine Physician
  • Gainesville, FL
National Provider Identifier
1699790527
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2012-01461 Issued in NC
Practice address
1600 SW Archer Rd
Gainesville, FL 32610
Phone
(352) 265-0680
Fax
(352) 372-3831
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME53785 FL
Pediatrics Physician 208000000X ME53785 FL
Pediatric Adolescent Medicine Physician 2080A0000X ME53785 FL
Internal Medicine Physician 207R00000X 2012-01461 NC Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610

Mailing address

PO Box 918025
Orlando, FL 32891-8025
Phone (352) 265-0680

Other practice location 1

800 N Justice St
Hendersonville, NC 28791-3410
Phone (828) 696-1000

Other identifiers 3

IdentifierTypeStateIssuer
064765900MedicaidFL
110228587OtherFLRR MEDICARE
P01451205OtherNCRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130731000563 NC Practitioner - Internal Medicine 1850425117 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2012-01461NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince Nov 1, 2014 Accepting new patients
Cogent Healthcare of North Carolina, PC Internal Medicine CurrentSince Aug 6, 2017 Accepting new patients
Hospitalist Medicine Physicians of North Carolina PLLC Internal Medicine CurrentSince Jul 29, 2017 Accepting new patients
Henderson County Hospital Corporation CurrentSince Nov 1, 2014 Accepting new patients

Locations

21 Turtle Creek Dr
Ste 100
Asheville, NC 28803
Phone (828) 435-8394

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

Organizations & group practices 4

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1699790527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-265-0680",
            "fax_number": "352-733-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32610",
            "telephone_number": "352-265-0680",
            "fax_number": "352-372-3831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N Justice St",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "NC",
            "postal_code": "287913410",
            "country_code": "US",
            "telephone_number": "828-696-1000",
            "fax_number": "828-694-7654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRINENKO",
        "first_name": "DAWN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME53785",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME53785",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME53785",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2012-01461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064765900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110228587",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01451205",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.