Individual provider Active NPI

Gretchen Elizabeth Grimaldos, CRNA

  • Certified Registered Nurse Anesthetist
  • Fairbanks, AK
National Provider Identifier
1962740605
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
157081 Issued in AK
Practice address
1650 Cowles St
Fairbanks, AK 99701-5907
Phone
(907) 459-3500
NPI assigned
Jan 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 157081 AK Primary
Certified Registered Nurse Anesthetist 367500000X 799878 TX

Addresses

Primary practice location

1650 Cowles St
Fairbanks, AK 99701-5907

Mailing address

PO Box 73720
Fairbanks, AK 99707-3720
Phone (682) 885-1855

Other practice location 1

801 7th Ave
Fort Worth, TX 76104-2733
Phone (682) 885-4054

Other names 1

  • Gretchen Elizabeth Geest Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130415000057 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062658297 Reassigns benefits to 2 organizations
I20200812003078 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062658297 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
157081AKMDCertified Registered Nurse Anesthetist
799878TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anchorage Anesthesia Medical Group, P.C. CurrentSince Aug 23, 2021 Accepting new patients
Cook Children's Physician Network CurrentSince Feb 25, 2013 Accepting new patients
Cook Children's Physician Network CurrentSince Feb 25, 2013 Accepting new patients
University Hospitals Medical Group Inc PastSince Aug 23, 2021 Accepting new patients

Locations

3300 Providence Dr
Ste 207
Anchorage, AK 99508
Phone (907) 279-0555

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1962740605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73720",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997073720",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015907",
            "telephone_number": "907-459-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761042733",
            "country_code": "US",
            "telephone_number": "682-885-4054",
            "fax_number": "682-885-7497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMALDOS",
        "first_name": "GRETCHEN",
        "middle_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-30",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "157081",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "799878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRETCHEN",
            "last_name": "GEEST",
            "middle_name": "ELIZABETH",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.