Individual provider Active NPI

Brooke B Grizzell, MD

  • Obstetrics & Gynecology Physician
  • Wichita, KS
National Provider Identifier
1720099781
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
04-31697 Issued in KS
Practice address
3600 E Harry St
Wichita, KS 67218-3713
Phone
(316) 268-7089
Fax
(316) 268-8098
NPI assigned
Aug 11, 2006
Last updated
Feb 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 04-31697 KS Primary

Addresses

Primary practice location

3600 E Harry St
Wichita, KS 67218-3713

Mailing address

PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135

Other identifiers 2

IdentifierTypeStateIssuer
003719128OtherMEDICARE
200399920CMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20060908000362 KS Practitioner - Obstetrics/Gynecology 6204830052 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-31697KSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Sep 1, 2011 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Sep 1, 2011 Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients
Via Christi Regional Medical Center Inc Obstetrics & Gynecology Past Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. Past Accepting new patients
Via Christi Regional Medical Center Past Accepting new patients

Locations

3009 N Cypress St
Wichita, KS 67226
Phone (316) 261-3111

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1720099781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135",
            "fax_number": "316-689-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 E HARRY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183713",
            "telephone_number": "316-268-7089",
            "fax_number": "316-268-8098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIZZELL",
        "first_name": "BROOKE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "04-31697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719128",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200399920C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.