Active NPI
Grayson Nathaniel Mynatt, DO
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1730757907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2024031283
- Practice address
- 4025 N Sheridan Rd
Chicago, IL 60613-2010 - Phone
- (773) 388-1600
- NPI assigned
- Jun 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2024031283 | MO | Primary |
| Family Medicine Physician | 207Q00000X | 036176984 | IL |
Addresses
Primary practice location
4025 N Sheridan Rd
Chicago, IL 60613-2010
Mailing address
4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600
Other practice location 1
551 Veterans United Dr
Columbia, MO 65201-8397
Phone (573) 884-7733
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MUDOCREFERRAL@direct.health.missouri.edu | Direct | Curators of the University of Missouri |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240813002463 | MO | Practitioner - Family Practice | 9032510557 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Hospital Dr
Dc032.00 Ma303
Columbia, MO 65212-0001
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.23 of 100
- Quality
- 58.17
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.92
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Curators of the University of Missouri | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Columbia, MO
- NPI 1699769901
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jefferson City, MO
- NPI 1174597892
-
- General Acute Care Hospital
- Columbia, MO
- NPI 1699769901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781654400000",
"number": "1730757907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 N SHERIDAN RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132010",
"telephone_number": "773-388-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 N SHERIDAN RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132010",
"telephone_number": "773-388-1600"
}
],
"practiceLocations": [
{
"address_1": "551 Veterans United Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MO",
"postal_code": "652018397",
"country_code": "US",
"telephone_number": "573-884-7733",
"fax_number": "573-882-6228",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MYNATT",
"first_name": "GRAYSON",
"middle_name": "NATHANIEL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-15",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2024031283",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036176984",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
"affiliation": "Y",
"endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
"affiliationName": "Curators of the University of Missouri",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct",
"address_1": "551 Veterans United Dr",
"city": "Columbia",
"state": "MO",
"country_code": "US",
"postal_code": "652018397",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.