Active NPI
Kimberly Ann Grandinetti, MD
- Pediatrics Physician
- Spokane, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00046330
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G8862602 | Other | WA | MEDICARE PTAN |
| 8459828 | Medicaid | WA | |
| P00419722 | Other | WA | MEDICARE 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD23090 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Community Health Association of Spokane | Current | Accepting new patients | |
| Community Health Association of Spokane | Current | Accepting new patients | |
| Community Health Association of Spokane | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Community Health Association of Spokane | Pediatrics | Past | Accepting new patients |
| Spokane Pediatrics PLLC | Pediatrics | Past | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1326005851
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1679363592
-
dba Perry Street Clinic
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1770972754
-
dba Everett Medical Center
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1396503058
Pediatrics
-
- Pediatrics Physician
- Spokane, WA
- NPI 1932680949
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.