Simonique Jessie-Allean Grissom

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0997794-NP Issued in CO

Practice address

777 Bannock St
Denver, CO 80204-4597

Phone

(303) 436-4949

Fax

(303) 602-4550

NPI assigned

May 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, NE2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hydr8 LLCGroup PAC ID 1456726884, 18 clinicians

4G Enterprises LLCGroup PAC ID 4789810508, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgrissom196405@direct.dhha.org

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.

• 4G Enterprises, LLC

  dba Rockbrook Urgent Care

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1033544267
  Medicare reassignment Care Compare group
• Hydr8, LLC

  dba West Omaha Urgent Care

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1922735406
  Medicare reassignment Care Compare group
• Denver Health and Hospital Authority

  • General Practice Physician
  • Denver, CO
  • NPI 1477569838
  Medicare reassignment NPD
• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1730166034
  Medicare reassignment NPD
• Harlan Medical, LLC

  dba Bellevue Urgent Care

  • Urgent Care Clinic/Center
  • Bellevue, NE
  • NPI 1487089611
  Medicare reassignment
• Make Medical, LLC

  dba Urgent Care Network Crossroads

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1295181022
  Medicare reassignment
• Urgent Care Bennington, LLC

  dba Bennington Urgent Care

  • Urgent Care Clinic/Center
  • Bennington, NE
  • NPI 1033940879
  Medicare reassignment
• Denver Health and Hospital Authority

  • Psychiatric Hospital Unit
  • Denver, CO
  • NPI 1689624942
  NPD
• Peak Vista Community Health Centers

  dba Behavioral Health at Inside Out Youth Services

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1871347443
  NPD

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1710623012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-4550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 S Union Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809103184",
            "country_code": "US",
            "telephone_number": "719-632-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "SIMONIQUE",
        "middle_name": "JESSIE-ALLEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0997794-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Joseph Grindler, M.D.
• Pamela K Griner
• Catherine H Grinnell, CNM
• Danielle Reilly Grisolano, DPT
• Lisa Marie Griss, MD
• Branum Gage Griswold, MD
• Jerry Grant Griswold II, NURSE'S AIDE
• Natalia M Grob, MD
• Laci Grobe
• Kerry A. Groce, CRNA

• Family Nurse Practitioner in Denver, CO
• Providers in Denver, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.