Active NPI
Michelle Linn Grigsby, PH.D.
- Clinical Psychologist
- San Antonio, TX
National Provider Identifier
1851554729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 34762
- Practice address
- 16170 Jones Maltsberger Rd Ste 202
San Antonio, TX 78247-3204 - Phone
- (210) 683-5975
- Fax
- (210) 714-3690
- NPI assigned
- Jul 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 34762 | TX | |
| Clinical Psychologist | 103TC0700X | 34762 | TX | Primary |
Addresses
Primary practice location
16170 Jones Maltsberger Rd Ste 202
San Antonio, TX 78247-3204
Mailing address
16418 Durango Creek Dr
San Antonio, TX 78247-4425
Phone (210) 683-5975
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0285249-06 | Medicaid | TX | |
| 215695747 | Other | TX | UNITED BEHAVIORAL HEALTH |
| 263982000 | Other | TX | MAGELLAN HEALTH SERVICES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180307000812 | TX | Practitioner - Psychologist Billing Independently | 8628339637 | Practice locations: San Antonio, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34762 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1851554729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16418 DURANGO CREEK DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782474425",
"telephone_number": "210-683-5975",
"fax_number": "210-714-3690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16170 JONES MALTSBERGER RD STE 202",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782473204",
"telephone_number": "210-683-5975",
"fax_number": "210-714-3690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGSBY",
"first_name": "MICHELLE",
"middle_name": "LINN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-09",
"last_updated": "2021-11-18",
"certification_date": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "34762",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "34762",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0285249-06",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "215695747",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN HEALTH SERVICES",
"identifier": "263982000",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.