Douglas William Grissom, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD153379 Issued in OR

Practice address

1151 May St
Suite 201
Hood River, OR 97031-1526

Phone

(541) 387-1300

Fax

(541) 386-6224

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Merit-based Incentive Payment System (MIPS)

Final score

95 of 100Reported as group

Quality

83.34

Promoting interoperability

100

Improvement activities

40

Cost

100

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Providence Health & Services Oregon

  dba Providence Hood River Memorial Hospital

  • Clinical Pathology Physician
  • Hood River, OR
  • NPI 1053862714

  Family Medicine

  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Hood River Memorial Hospital

  • Critical Access Hospital
  • Hood River, OR
  • NPI 1255429338
  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Hood River Memorial Hospital - Rural Health Clinic

  • Rural Health Clinic/Center
  • Hood River, OR
  • NPI 1073100095
  NPD

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1932326493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3390",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 MAY ST",
            "address_2": "SUITE 201",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311526",
            "telephone_number": "541-387-1300",
            "fax_number": "541-386-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "DOUGLAS",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "9966",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD153379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500690452",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgrissom543732@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1151 May St",
            "address_2": "SUITE 201",
            "city": "Hood River",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970311526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyler Thomas Gray, MD
• Stefanie Greenleaf
• Kathy Grewe, MD
• Nathan Louis Griffel Wild
• Naomi Grimsley, OTR/L
• Angela Gross, LMT
• Orville Grout
• Deida Isabel Guzman Peralta
• Gynknow LLC
• Sara Halstead

• Family Medicine Physician in Hood River, OR
• Providers in Hood River, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.