CHARLES KEVIN GRIGSBY (NPI# 1114366028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114366028 |
| Entity Type | Individual |
| Full Name | CHARLES KEVIN GRIGSBY |
| Credential | M.D. |
| Practice Address |
825 Fairfax Ave Ste 610 Norfolk VA 23507-1912 |
| Mailing Address |
Po Box 936 Norfolk VA 23501-0936 |
| Practice Telephone | 7574468960 |
| Practice Fax Number | 7574465197 |
| Mailing Telephone | 7574468960 |
| Mailing Fax Number | 7574465197 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
0101265120 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184636003 | Charles Gary Grigsby Jr. | Internal Medicine | 216 West Walnut Street, Panville, KY 40422 | 2006-08-12 |
| 1649809740 | Charles Gary Grigsby IIi | Student in an Organized Health Care Education/Training Program | 900 South Limestone Ctw 304, Lexington, KY 40536-0001 | 2020-04-02 |
| Street Address |
825 FAIRFAX AVE STE 610 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942270624 | Rachel A Burke | Surgery | 825 Fairfax Ave Ste 610, Norfolk, VA 23507 | 2006-01-25 |
| 1306465133 | Tracey Pu | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2020-04-12 |
| 1376171306 | Maxwell Solomon Wagner | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2020-03-27 |
| 1801423967 | Charles Thomas Hehman | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2020-03-26 |
| 1528521416 | Joseph Felix Mullen | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2019-04-09 |
| 1831658780 | Aubrie Lauren Finlay | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2019-03-19 |
| 1407344823 | Monika Tedeschi | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507 | 2018-05-01 |
| 1326545591 | Vincent Guang Yang | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2018-04-12 |
| 1790280360 | Geoffrey Andrew Boisvert | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1912 | 2018-03-27 |
| 1003311861 | Ricardo Emmanuel Rendel | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2018-03-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
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| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255621900 | Michael T Martyak | Surgery | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2011-04-14 |
| 1609019314 | Jessica Robin Burgess | Surgery | 825 Fairfax Ave, Suite 610, Norfolk, VA 23507-1914 | 2009-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500754 | Juan Carlos Torres | Surgery | 4100 David Ln, Alexandria, VA 22311-1113 | 2020-08-29 |
| 1770132409 | Hiba Ezzeddine | Surgery | Vcuhs Dept of Acute Care Surgery Fellowship, 980454, 1250 E. Marshall Street, Richmond, VA 23298-0454 | 2019-09-05 |
| 1669943890 | Taylor Erin D'etcheverry | Surgery | 20560 Southport Landing Pl, Smithfield, VA 23430-8116 | 2018-12-16 |
| 1780997080 | Dustin Donley | Surgery | 7101 Jahnke Rd Bldg Suite260, Richmond, VA 23225-4017 | 2010-07-15 |
| 1417936493 | Joseph Charles Babrowicz Jr. | Surgery | 3299 Woodburn Rd Ste 230, Annandale, VA 22003-7319 | 2006-01-10 |
| 1831487479 | Asanthi Marian Ratnasekera | Surgery | 1250 E Marshall St, Pob 980257, Richmond, VA 23298-0257 | 2011-07-18 |
| 1104116235 | John Patrick Davis | Surgery | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2011-04-11 |
| 1952625576 | Jacob R Gillen | Surgery | 1906 Belleview Ave Se, Roanoke, VA 24014 | 2010-03-25 |
| 1700028172 | Stefan Leichtle | Surgery | 1250 E Marshall St, Dept. of Surgery/acute Care Surgical Services, Richmond, VA 23298-5051 | 2009-04-01 |
| 1457551707 | Katie Love Bower | Surgery | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2007-07-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.