Sarah E Grissom, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3294 Issued in TN

Practice address

4101 Dayton Blvd
Red Bank, TN 37415-7156

Phone

(423) 499-7710

Fax

(423) 499-7711

NPI assigned

Sep 15, 2009

Last updated

May 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Mount Sinai School of Medicine

  • Family Medicine Physician
  • New York, NY
  • NPI 1528538774
  NPD (past)
• One Medical of Ny, P.C.

  dba One Medical Group

  • Family Medicine Physician
  • New York, NY
  • NPI 1861709487
  NPD (past)

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1932432416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 DAYTON BLVD",
            "city": "RED BANK",
            "state": "TN",
            "postal_code": "374157156",
            "telephone_number": "423-499-7710",
            "fax_number": "423-499-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 DAYTON BLVD",
            "city": "RED BANK",
            "state": "TN",
            "postal_code": "374157156",
            "telephone_number": "423-499-7710",
            "fax_number": "423-499-7711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Embarcadero Ctr Lbby Level",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941113823",
            "country_code": "US",
            "telephone_number": "415-578-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Madison Ave",
            "address_2": "25th Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100225403",
            "country_code": "US",
            "telephone_number": "212-530-0650",
            "fax_number": "212-867-4353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "SARAH",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3294",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "016538",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-01972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ava Rose Dettore, PA
• Cassandra Marie Englert, MSPT
• Anthony Lamar Evans, PHARM-D
• Lindsay Evans, PHARMD
• Fast Pace Medical Clinic PLLC
• Grow and Thrive Counseling
• Randy Scott Hall, RPH
• Kayla Turner Hickman, PHARM.D.
• Susan Elaine Hickman, PHD, PSYD
• Lindsay Erin Johnson, DPT

• Physician Assistant in Red Bank, TN
• Providers in Red Bank, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.