Individual provider Active NPI

Rhonda Renee Grigg, M.D.

  • Pediatrics Physician
  • Pueblo, CO
National Provider Identifier
1780811893
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
39333 Issued in CO
Practice address
332 S Orchard Springs Dr. 150
Pueblo, CO 81007
Phone
(719) 253-7640
Fax
(719) 253-7644
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 39333 CO Primary
Pediatrics Physician 208000000X 35.060545 OH

Addresses

Primary practice location

332 S Orchard Springs Dr. 150
Pueblo, CO 81007

Mailing address

332 S Orchard Springs Dr Ste 150
Pueblo, CO 81007-6154
Phone (719) 253-7640

Other identifiers 1

IdentifierTypeStateIssuer
86989260MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160907001113 CO Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3072809706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39333COMDPediatrics Physician
35.060545OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Small World Pediatrics LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rhonda.grigg.1@18256.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18256/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1780811893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 S ORCHARD SPRINGS DR STE 150",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810076154",
            "telephone_number": "719-253-7640",
            "fax_number": "719-253-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 S ORCHARD SPRINGS DR. 150",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81007",
            "telephone_number": "719-253-7640",
            "fax_number": "719-253-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGG",
        "first_name": "RHONDA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "39333",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.060545",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86989260",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.