Leon M Grigoryev, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20728 Issued in MS

Practice address

1 Layfair Dr
Suite 100
Flowood, MS 39232-9717

Phone

(601) 936-8801

Fax

(601) 936-8808

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ms Methodist Hospital & Rehabilitation Center

  • Clinical Neuropsychologist
  • Jackson, MS
  • NPI 1285772293
  Medicare reassignment NPD
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Brookhaven, MS
  • NPI 1689461626
  NPD
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Jackson, MS
  • NPI 1790711273
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1790876811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LAYFAIR DR",
            "address_2": "SUITE 100",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329717",
            "telephone_number": "601-936-8801",
            "fax_number": "601-936-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAYFAIR DR",
            "address_2": "SUITE 100",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329717",
            "telephone_number": "601-936-8801",
            "fax_number": "601-936-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGORYEV",
        "first_name": "LEON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MS",
            "license": "20728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WINDSOR MEDICARE",
            "identifier": "407739",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina M Gregg, NP-C
• Greggory E. Tharp DMD Inc
• Gregory Gordon MD, PLLC
• Caleb Van Gressett, DC
• Anna Kathryn Griffin, FNP-C
• Grace Kim Guillory, RNFA
• Avinash C Gulanikar, M.D,
• Ashley Caroline Gullette-Torres, FNP-C
• Jamie Guyton, LPC
• Karla Haik, D.M.D.

• Physical Medicine & Rehabilitation Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Physical Medicine & Rehabilitation Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.