Jelana Grissom, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

344810 Issued in NY

Practice address

124 Rosa Rd
Suite 382
Schenectady, NY 12308

Phone

(518) 386-3691

Fax

(518) 386-3553

NPI assigned

Sep 12, 2019

Last updated

Oct 24, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, FL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgrissom834562@direct.trinity-health.org

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.

• Beacon Health Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1679393052
  Medicare reassignment NPD
• Schenectady Pulmonary & Critical Care Associates PC

  • Pulmonary Disease Physician
  • Schenectady, NY
  • NPI 1013042084
  Medicare reassignment

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1750931739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 ROSA RD",
            "address_2": "SUITE 382",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12308",
            "telephone_number": "518-386-3691",
            "fax_number": "518-386-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 ROSA RD",
            "address_2": "SUITE 382",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12308",
            "telephone_number": "518-386-3691",
            "fax_number": "518-386-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "JELANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Grevious
• Keimani Griffin
• Keisiah Griffin, RN
• Teresa Griffin
• Erin Kathryn Grimm, M.S.ED., MHC
• Jeanne J Grosso, D.M.D.
• Margaret Grot, RPN
• Grow With the Flow, Mental Health Counseling, PLLC
• Jennifer J Gruda, RDH
• Michael K. Grugan, PA

• Family Nurse Practitioner in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.