Individual provider Active NPI

Sheri Shannon Grisso, ARNP

  • Family Nurse Practitioner
  • Loxahatchee, FL
National Provider Identifier
1801058052
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3357122 Issued in FL
Practice address
13005 Southern Blvd Ste 122
Medical Mall One, Suite 122
Loxahatchee, FL 33470-9231
Phone
(561) 842-5050
Fax
(561) 793-9989
NPI assigned
Jun 30, 2008
Last updated
Oct 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP3357122 FL Primary

Addresses

Primary practice location

13005 Southern Blvd Ste 122
Medical Mall One, Suite 122
Loxahatchee, FL 33470-9231

Mailing address

13005 Southern Blvd Ste 122
Medical Mall One, Suite 122
Loxahatchee, FL 33470-9231
Phone (561) 842-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090109000565 FL Practitioner - Nurse Practitioner 1153498092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13005 Southern Blvd
Loxahatchee, FL 33470-9231
Phone (561) 793-9909

13005 Southern Boulevard
Suite 122 Medical Mall One
Loxahatchee, FL 33470-9231

National Provider Directory

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319760000000",
    "number": "1801058052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD STE 122",
            "address_2": "MEDICAL MALL ONE, SUITE 122",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709231",
            "telephone_number": "561-842-5050",
            "fax_number": "561-793-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD STE 122",
            "address_2": "MEDICAL MALL ONE, SUITE 122",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709231",
            "telephone_number": "561-842-5050",
            "fax_number": "561-793-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSO",
        "first_name": "SHERI",
        "middle_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2011-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3357122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loxahatchee, FL

Sources for this page

Verify at the official NPI Registry.