Shannon Gryskwicz

Primary specialty

DenturistTaxonomy code 122400000X

License

5007 Issued in ME

Practice address

54 York St
Kennebunk, ME 04043-7157

Phone

(207) 985-0210

Fax

(207) 985-8068

NPI assigned

Mar 27, 2014

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

Other names 1

• Shannon Gryskwicz Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Gryskwicz LLC

  • Denturist
  • Kennebunk, ME
  • NPI 1912456401
  NPD (past) Authorized official

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1780001735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 354",
            "city": "STANDISH",
            "state": "ME",
            "postal_code": "040840354",
            "telephone_number": "207-985-0210",
            "fax_number": "207-642-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 YORK ST",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040437157",
            "telephone_number": "207-985-0210",
            "fax_number": "207-985-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRYSKWICZ",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "ME",
            "license": "5007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "GRYSKWICZ",
            "credential": "LD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• John P Gmeiner, PHD
• Lisa Gouldsbrough, D.O.
• Joseph Grandonico
• Alexander Gray, PT, DPT
• Gryskwicz LLC
• Pam L Guilbeault, PA-C
• Jennifer Helen Gustafson, OTR/L
• Karlene Hafemann, LCSW
• Theresa T Haggett
• Marcia L Hall, LCPC

• Denturist in Kennebunk, ME
• Providers in Kennebunk, ME by specialty
• Denturist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.