Individual provider Active NPI

Mitzi S Gragson, NP

  • Nurse Practitioner
  • Yuma, AZ
National Provider Identifier
1992887459
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
262965 Issued in AZ
Practice address
11351 S Frontage Rd
Yuma, AZ 85367-7862
Phone
(928) 336-4000
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP14623 CA
Nurse Practitioner 363L00000X 262965 AZ Primary

Addresses

Primary practice location

11351 S Frontage Rd
Yuma, AZ 85367-7862

Mailing address

2400 S Avenue a
Yuma, AZ 85364-7170
Phone (928) 344-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050330001259 CA Practitioner - Nurse Practitioner 3678520863 Reassigns benefits to 1 organization
I20211203000598 AZ Practitioner - Nurse Practitioner 3678520863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical Center 367 clinicians

Practice addresses (Care Compare)

2911 S 8TH Ave
Yuma, AZ 85364-8000
Phone (928) 783-3050

Hospital & facility affiliations

  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14623CAMDAudiologist
262965AZMDNurse Practitioner
NP14623CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Valley Family Care Medical Group Apc CurrentSince Jul 31, 2016 Accepting new patients
Yuma Regional Medical Center CurrentSince Dec 27, 2021 Accepting new patients
Imperial Valley Family Care Medical Group, Apc CurrentSince Jul 31, 2016 Accepting new patients

Locations

2911 S 8th Ave
Yuma, AZ 85364
Phone (928) 783-3050

11351 S Frontage Rd
Yuma, AZ 85367
Phone (928) 336-2000

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100

2109 Ross Ave
El Centro, CA 92243
Phone (760) 352-4103

516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1992887459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647170",
            "telephone_number": "928-344-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11351 S FRONTAGE RD",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853677862",
            "telephone_number": "928-336-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAGSON",
        "first_name": "MITZI",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP14623",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "262965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.