Individual provider Active NPI

Kristi J Grall, MD

  • Emergency Medicine Physician
  • Tucson, AZ
National Provider Identifier
1851342604
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35503 Issued in AZ
Practice address
2800 E Ajo Way
Hospital Based @ Kino Hospital
Tucson, AZ 85713-6204
Phone
(520) 874-7400
Fax
(520) 874-3425
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 46792 WI
Emergency Medicine Physician 207P00000X 35503 AZ Primary

Addresses

Primary practice location

2800 E Ajo Way
Hospital Based @ Kino Hospital
Tucson, AZ 85713-6204

Mailing address

2701 E Elvira Rd
Tucson, AZ 85706-7124
Phone (520) 874-3500

Other identifiers 2

IdentifierTypeStateIssuer
P00337338OtherAZRR MEDICARE
111759MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20140627000482 MN Practitioner - Emergency Medicine 9931174067 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35503AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regions Hospital Emergency Medicine CurrentSince Aug 1, 2014 Accepting new patients
Regions Hospital CurrentSince Aug 1, 2014 Accepting new patients

Locations

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

640 Jackson St
#11102F
Saint Paul, MN 55101
Phone (651) 254-3456

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1851342604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E ELVIRA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857067124",
            "telephone_number": "520-874-3500",
            "fax_number": "520-874-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E AJO WAY",
            "address_2": "HOSPITAL BASED @ KINO HOSPITAL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136204",
            "telephone_number": "520-874-7400",
            "fax_number": "520-874-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRALL",
        "first_name": "KRISTI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "46792",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "35503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00337338",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111759",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.