Individual provider Active NPI

Garyn Grijalva, FNP-BC

  • Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1770383101
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
320120 Issued in AZ
Practice address
1895 N Jasper Dr Ste 1
Flagstaff, AZ 86001-1632
Phone
(928) 773-2332
NPI assigned
Mar 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 320120 AZ
Nurse Practitioner 363L00000X 320120 AZ Primary

Addresses

Primary practice location

1895 N Jasper Dr Ste 1
Flagstaff, AZ 86001-1632

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250523002709 AZ Practitioner - Nurse Practitioner 1951820752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

1895 N Jasper Dr
Flagstaff, AZ 86001-1632

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince May 16, 2025 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince May 16, 2025 Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1895 N Jasper Dr
Ste 1
Flagstaff, AZ 86001
Phone (928) 213-6527

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1770383101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-779-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 N JASPER DR STE 1",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011632",
            "telephone_number": "928-773-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIJALVA",
        "first_name": "GARYN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "320120",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "320120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.