Bradley Wayne Grissom, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209005691 Issued in IL

Practice address

516 W Madison St
Danville, IL 61832-5657

Phone

(217) 554-1700

Fax

(217) 554-1704

NPI assigned

Feb 21, 2007

Last updated

Mar 12, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Hoopeston Community Memorial HospitalGroup PAC ID 3577456037, shared by 11 NPIs, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
• Carle Hoopeston Regional Health Center Hospital, Hoopeston, IL, CCN 141316

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bgrissomnp21669@carlehiedirect.net

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.

• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Hoopeston Community Memorial Hospital

  dba Hoopeston Physician Group

  • Internal Medicine Physician
  • Hoopeston, IL
  • NPI 1043683014
  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  dba Charlotte Ann Russell Medical Center

  • Rural Health Clinic/Center
  • Hoopeston, IL
  • NPI 1578504544
  NPD
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Carle Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Danville, IL
  • NPI 1225194533

  Hospital

  Care Compare affiliation
• Hoopeston Community Memorial Hospital

  dba Hoopeston Community Ambulance

  • Ambulance
  • Hoopeston, IL
  • NPI 1164594594

  Hospital

  Care Compare affiliation
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  Care Compare affiliation
• The Carle Foundation Hospital

  • General Acute Care Hospital
  • Urbana, IL
  • NPI 1013071653
  Care Compare affiliation

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1891830402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6002",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036002",
            "telephone_number": "217-326-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W MADISON ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325657",
            "telephone_number": "217-554-1700",
            "fax_number": "217-554-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "BRADLEY",
        "middle_name": "WAYNE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209005691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damon C. Green, M.D.
• Laura Green, LCSW
• Patsy Ann Green, RN, CDE
• Danny Robert Grider, O.D.
• Mary Ellen Grilly, DDS
• Taylor Grove
• Katy Ann Grubbs, COTA/L
• Maleah Grussing, N.P.
• Steven Dale Hackman, PT
• Kerry L Hall, APRN, CNP

• Nurse Practitioner in Danville, IL
• Providers in Danville, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.