NPIMap

Individual provider Active NPI

Kathleen M. Moss Grizzard, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1770593923
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME33818 Issued in FL
Practice address
4108 Henderson Blvd
Tampa, FL 33629-5750
Phone
(813) 289-4321
Fax
(813) 287-2949
NPI assigned
Aug 9, 2006
Last updated
Jan 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME33818 FL Primary

Addresses

Primary practice location

4108 Henderson Blvd
Tampa, FL 33629-5750

Mailing address

4108 Henderson Blvd
Tampa, FL 33629-5750
Phone (813) 289-4321

Other identifiers 3

IdentifierTypeStateIssuer
00004389OtherFLUNITED
30475OtherFLBCBS
110178342OtherFLRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902000361 FL Practitioner - Internal Medicine 9234253956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Whitaker,Weintraub and Grizzard, MD,PAGroup PAC ID 1456329986, 5 clinicians

Practice addresses (Care Compare)

4108 Henderson Blvd
Tampa, FL 33629-5750
Phone (813) 289-4321

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Whitaker,Weintraub & Grizzard, MD,PA Internal Medicine CurrentSince Mar 1, 1999 Accepting new patients
John Q Stauffer Mdpa Past Accepting new patients

Locations

4108 Henderson Blvd
Tampa, FL 33629
Phone (813) 289-4321

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1770593923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295750",
            "telephone_number": "813-289-4321",
            "fax_number": "813-287-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295750",
            "telephone_number": "813-289-4321",
            "fax_number": "813-287-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS GRIZZARD",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME33818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "00004389",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30475",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "110178342",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.