John Grisham, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-39459 Issued in KS

Practice address

11725 W 112TH St
Overland Park, KS 66210

Phone

(913) 469-5579

NPI assigned

Jun 4, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS, OH2 enrollments

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 2

Specialty

Family Practice

Education

University of Oklahoma College of Medicine, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Overland Park Reg Med Ctr Hospital, Overland Park, KS, CCN 170176
• Menorah Medical Center Hospital, Overland Park, KS, CCN 170182

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.grisham@hca2.eclinicaldirectplus.com

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.

• Hospital District No 1 Marion Co

  • Critical Access Hospital
  • Marion, KS
  • NPI 1144355793
  Medicare reassignment NPD
• Hospital District No 1 Marion Co

  • Critical Access Hospital
  • Marion, KS
  • NPI 1326087966
  Medicare reassignment NPD
• Inpatient Consultants of Kansas PA

  • Internal Medicine Physician
  • Overland Park, KS
  • NPI 1548563737

  Family Medicine

  Medicare reassignment NPD
• Hospital District No 1 Marion Co

  • Durable Medical Equipment & Medical Supplies
  • Marion, KS
  • NPI 1427266014
  NPD
• Overland Park Surgical Specialties LLC

  • Family Medicine Physician
  • Overland Park, KS
  • NPI 1760798540
  NPD
• Inpatient Consultants of Kansas PA

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1225331002

  Family Medicine

  NPD
• College Park Family Care Center PA

  • Family Medicine Physician
  • Overland Park, KS
  • NPI 1740248772
  NPD (past)
• College Park Family Care Center, P.a.

  • Ambulatory Surgical Clinic/Center
  • Overland Park, KS
  • NPI 1861415846
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Midwest Division - MMC, LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1255378337
  Care Compare affiliation
• Midwest Division-Oprmc LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1578500484
  Care Compare affiliation

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1972983849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741331",
            "telephone_number": "913-469-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11725 W 112TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-469-5579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 E Murdock St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "67208",
            "country_code": "US",
            "telephone_number": "316-689-9107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 S Freeborn St",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "KS",
            "postal_code": "668611256",
            "country_code": "US",
            "telephone_number": "620-382-2177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3311 E Murdock St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "67208",
            "country_code": "US",
            "telephone_number": "316-689-9107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-39459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201147120B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody A Grigsby, PT
• Nicole Yvonne Grimm, PTA
• Ryan J. Grindstaff, MD, PHD
• Justin Arik Gripentrog, CCC-SLP
• Chris Grisafe-Pont
• Adam Grooms, M.D.
• Jamie Michelle Groover, RBT
• Kelly F Grosdidier, OD
• Jeremy Alexander Gross
• Lucilene A. Gross, BCBA

• Family Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.