Individual provider Active NPI

Elizabeth Grijalva, APRN-CNP

  • Family Nurse Practitioner
  • Douglas, AZ
National Provider Identifier
1942059993
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
230180 Issued in AZ
Practice address
1100 N F Ave
Douglas, AZ 85607-1919
Phone
(520) 364-3285
Fax
(520) 364-3378
NPI assigned
May 14, 2024
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 230180 AZ Primary

Addresses

Primary practice location

1100 N F Ave
Douglas, AZ 85607-1919

Mailing address

1205 N F Ave
Douglas, AZ 85607-1920
Phone (520) 364-1429

Other practice location 1

6911 N Bdi Blvd
Douglas, AZ 85607-6202
Phone (520) 364-7521 ext. 34480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20250619002160 AZ Practitioner - Nurse Practitioner 7719498393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 N F Ave
Douglas, AZ 85607-1919
Phone (502) 364-3285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
230180AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chiricahua Community Health Centers, Inc. CurrentSince Jul 7, 2025 Accepting new patients
Chiricahua Community Health Centers, Inc CurrentSince Jul 7, 2025 Accepting new patients
Chiricahua Community Health Centers, Inc Current Accepting new patients

Locations

335 S Ocotillo St
Benson, AZ 85602
Phone (520) 326-4811

108 Arizona St
Bisbee, AZ 85603
Phone (520) 432-3309

1100 N F Ave
Douglas, AZ 85607
Phone (520) 364-3285

1111 N F Ave
Douglas, AZ 85607
Phone (520) 364-6860

1151 E 16th St
Douglas, AZ 85607
Phone (520) 364-5437

1205 N F Ave
Douglas, AZ 85607
Phone (520) 364-6852

815 E 15th St
Douglas, AZ 85607
Phone (520) 364-5437

10566 N Highway 191
Elfrida, AZ 85610
Phone (520) 642-2222

155 Calle Portal
Ste 300
Sierra Vista, AZ 85635
Phone (520) 458-6331

155 Calle Portal
Ste 700
Sierra Vista, AZ 85635
Phone (520) 459-0203

251 W Rex Allen Dr
Willcox, AZ 85643

Interoperability endpoints

  • Direct secure messaging: elizabeth.grijalva.p1@direct.cchci.nextgenshare.com

Organizations & group practices 3

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": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1942059993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-1429",
            "fax_number": "520-515-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071919",
            "telephone_number": "520-364-3285",
            "fax_number": "520-364-3378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6911 N Bdi Blvd",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "AZ",
            "postal_code": "856076202",
            "country_code": "US",
            "telephone_number": "520-364-7521 x34480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIJALVA",
        "first_name": "ELIZABETH",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "230180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, AZ

Sources for this page

Verify at the official NPI Registry.