Individual provider Active NPI

Robert Hopkins Grigsby Jr., DDS

  • General Practice Dentistry
  • Beloit, WI
National Provider Identifier
1912915661
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1606 G Issued in WI
Practice address
2149 Pioneer Dr
Beloit, WI 53511-3057
Phone
(608) 362-5712
Fax
(608) 362-3359
NPI assigned
Aug 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1606 G WI Primary

Addresses

Primary practice location

2149 Pioneer Dr
Beloit, WI 53511-3057

Mailing address

2149 Pioneer Dr
Beloit, WI 53511-3057
Phone (608) 362-5712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160115001518 WI Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 6103129606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1606 GWIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Grigsby & Chiera S C General Practice Past Accepting new patients

Organizations & group practices 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912915661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 PIONEER DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113057",
            "telephone_number": "608-362-5712",
            "fax_number": "608-362-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 PIONEER DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113057",
            "telephone_number": "608-362-5712",
            "fax_number": "608-362-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGSBY",
        "first_name": "ROBERT",
        "middle_name": "HOPKINS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1606 G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.