Individual provider Active NPI

Emily Wyatt Grigsby, M.D.

  • Emergency Medicine Physician
  • Huntington Beach, CA
National Provider Identifier
1861524415
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
95839 Issued in CA
Practice address
17772 Beach Blvd
Huntington Beach, CA 92647-6819
Phone
(714) 843-5059
Fax
(714) 375-7690
NPI assigned
Mar 9, 2007
Last updated
Dec 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 95839 CA Primary

Addresses

Primary practice location

17772 Beach Blvd
Huntington Beach, CA 92647-6819

Mailing address

701 Welch Rd
BLDG C
Palo Alto, CA 94304-1709
Phone (650) 723-9215

Other identifiers 1

IdentifierTypeStateIssuer
1861524415MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95839CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beach Emergency Medical Associates Emergency Medicine PastSince Nov 15, 2020 Accepting new patients
Steward Medical Group, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1861524415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WELCH RD",
            "address_2": "BLDG C",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041709",
            "telephone_number": "650-723-9215",
            "fax_number": "650-723-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17772 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476819",
            "telephone_number": "714-843-5059",
            "fax_number": "714-375-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGSBY",
        "first_name": "EMILY",
        "middle_name": "WYATT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "95839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861524415",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.