Individual provider Active NPI

Kimberly Ann Grandinetti, MD

  • Pediatrics Physician
  • Spokane, WA
National Provider Identifier
1801888524
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00046330 Issued in WA
Practice address
322 W North River Dr
Spokane, WA 99201-3208
Phone
(509) 324-6464
Fax
(509) 324-3726
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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 MD23090 OR
Pediatrics Physician 208000000X MD00046330 WA Primary

Addresses

Primary practice location

322 W North River Dr
Spokane, WA 99201-3208

Mailing address

322 W North River Dr
Spokane, WA 99201-3208
Phone (509) 324-6464

Other identifiers 3

IdentifierTypeStateIssuer
G8862602OtherWAMEDICARE PTAN
8459828MedicaidWA
P00419722OtherWAMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20061005000628 WA Practitioner - Pediatric Medicine 0941206460 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23090ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince May 22, 2011 Accepting new patients
Community Health Association of Spokane CurrentSince Feb 1, 2024 Accepting new patients
Community Health Association of Spokane CurrentSince Feb 1, 2024 Accepting new patients
Community Health Association of Spokane Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince May 22, 2011 Accepting new patients
Community Health Association of Spokane Pediatrics Past Accepting new patients
Spokane Pediatrics PLLC Pediatrics PastSince Mar 2, 2021 Accepting new patients

Locations

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

322 W North River Dr
Spokane, WA 99201
Phone (509) 241-2575

3919 N Maple St
Spokane, WA 99205
Phone (509) 326-6900

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

611 N Iron Bridge Way
Spokane, WA 99202

315 W 9th Ave
Ste 200
Spokane, WA 99204
Phone (509) 624-3126

601 W 5th Ave
Ste 200
Spokane, WA 99204
Phone (509) 960-8894

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: kimberly.grandinetti.1@11411.direct.athenahealth.com

Organizations & group practices 7

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1801888524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 W NORTH RIVER DR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013208",
            "telephone_number": "509-324-6464",
            "fax_number": "509-324-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W NORTH RIVER DR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013208",
            "telephone_number": "509-324-6464",
            "fax_number": "509-324-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDINETTI",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD23090",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00046330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8862602",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8459828",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00419722",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.