Individual provider Active NPI

Melissa Brooke Grisham, CRNP

  • Nurse Practitioner
  • Cullman, AL
National Provider Identifier
1831781855
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-169179 Issued in AL
Practice address
1912 Al Highway 157
Cullman, AL 35058-0609
Phone
(256) 737-2000
Fax
(256) 737-2152
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-169179 AL Primary

Addresses

Primary practice location

1912 Al Highway 157
Cullman, AL 35058-0609

Mailing address

1912 Al Highway 157
Cullman, AL 35058-0609
Phone (256) 737-2000

Other practice location 1

701 Princeton Ave SW
Birmingham, AL 35211-1303
Phone (205) 783-3500 ext. 1

Other names 1

  • Mrs. Melissa Brooke Golden Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20221011001495 AL Practitioner - Nurse Practitioner 8224404512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3400 Hwy 78 E
Jasper, AL 35501-8956
Phone (205) 387-4000

Hospital & facility affiliations

  • Walker Baptist Medical Center Hospital, Jasper, AL, CCN 010089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation Nurse Practitioner CurrentSince Dec 1, 2024 Accepting new patients
Cullman Regional Medical Group Hospitalists LLC CurrentSince Oct 10, 2022 Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

3400 Highway 78 E
Jasper, AL 35501
Phone (205) 387-4000

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1831781855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580609",
            "telephone_number": "256-737-2000",
            "fax_number": "256-737-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580609",
            "telephone_number": "256-737-2000",
            "fax_number": "256-737-2152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Princeton Ave SW",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352111303",
            "country_code": "US",
            "telephone_number": "205-783-3500 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "MELISSA",
        "middle_name": "BROOKE",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-169179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "GOLDEN",
            "middle_name": "BROOKE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.