Kathleen Brewer Grissett, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME100502 Issued in FL

Practice address

165 Wells Rd
Suite 408
Orange Park, FL 32073-3035

Phone

(904) 269-7200

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of South Florida College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

First Coast Mental Health P aGroup PAC ID 1658435482, 5 clinicians

Practice addresses (Care Compare)

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.

• First Coast Mental Health P a

  • Psychiatry Physician
  • Orange Park, FL
  • NPI 1285884650
  Medicare reassignment Care Compare group NPD
• First Coast Center for Counseling Inc

  • Clinical Social Worker
  • Orange Park, FL
  • NPI 1366692493
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1821170085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 WELLS RD",
            "address_2": "SUITE 408",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733035",
            "telephone_number": "904-269-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 WELLS RD",
            "address_2": "SUITE 408",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733035",
            "telephone_number": "904-269-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSETT",
        "first_name": "KATHLEEN",
        "middle_name": "BREWER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "25835",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME100502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Nichole Griffenkranz, OTD, OTR/L
• Maranda Griffin, PHD, LPC
• Torquita T Griffin
• Janet McCullough Grim, MA LMFT PA
• Travis R Grimes
• Jonathan C Groh, M.D.
• Kenneth Laurence Groleau
• Megan Grossi, PT, DPT , BSEP
• Shae Grossman
• Growing Minds Outside the Box

• Psychiatry Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.