Klarissa Grissom

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2204001085 Issued in VA

Practice address

14800 Joplin Rd
Manassas, VA 20112-3909

Phone

(703) 791-8081

NPI assigned

Dec 15, 2022

Last updated

Mar 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Faseler McCreary PLLC

  dba North Texas Voice and Speech

  • Hearing and Speech Clinic/Center
  • Austin, TX
  • NPI 1346867967

  Speech-Language Pathologist

  Medicare reassignment NPD
• My Possibilities

  • Speech-Language Pathologist
  • Plano, TX
  • NPI 1639747066
  NPD (past)

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1740992254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 HUFFINES BLVD APT 2205",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106560",
            "telephone_number": "314-914-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 JOPLIN RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123909",
            "telephone_number": "703-791-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "KLARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "119604",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204001085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belinda Greis, MS, CCC-SLP
• Francis Mervan Gress Jr., M.D.
• Kendra M Griffin, LCSW
• Anna Grimberg, RN
• Tiffany Grimm, PHARM D
• Lauren Grissom, DPT, PT
• Frederick P Grois III, M.D.
• Tyler Grosskopf, LPC
• Lisa Grossman, LPC
• Gloria Ann Grover, M.D.

• Speech-Language Pathologist in Manassas, VA
• Providers in Manassas, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.