LISA M GRIMALDI (NPI# 1447319306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447319306 |
| Entity Type | Individual |
| Full Name | LISA M GRIMALDI |
| Credential | MD |
| Practice Address |
1919 E Thomas Rd Phoenix AZ 85016 |
| Mailing Address |
3200 E Camelback Rd Ste 250 Phoenix AZ 85018-2327 |
| Practice Telephone | 6029331784 |
| Practice Fax Number | 6029331785 |
| Mailing Telephone | 6029331813 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2018-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
C10012364 | DE | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
36853 | AZ | Allopathic & Osteopathic Physicians |
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
25MA07959500 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0074624 | 05 | |
| DE | 250387785 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790051274 | Lisa Grimaldi | Physician Assistant | 1110 E Routt 66, Suite 100, Flagstaff, AZ 86001 | 2012-03-28 |
| 1013242429 | Lisa N Grimaldi | Internal Medicine | 900 S Caton Ave, Baltimore, MD 21229-5201 | 2009-10-03 |
| Street Address |
1919 E THOMAS RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162953 | Richard N Southard | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2005-05-31 |
| 1265049472 | Chelsea Agricola | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-30 |
| 1871109686 | Madeline Rose Mcnamee | Audiologist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-17 |
| 1699380212 | Lindsey N Manz | Dietitian, Registered | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-10 |
| 1376156331 | Jena Paige Buck | Occupational Therapist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-28 |
| 1386257244 | Alia Torfa | Registered Nurse | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-28 |
| 1336751999 | Cassandra E Martinez | Registered Nurse | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-17 |
| 1811508708 | Clara A Hart | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-13 |
| 1811505571 | Daniela M Giralt | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-07-20 |
| 1902424179 | Soren B Mickelsen | Speech-Language Pathologist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-07-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
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| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306467154 | Pediatrics Healthcare Associates | Pediatrics | 10645 N Tatum Blvd Ste C200-272, Phoenix, AZ 85028-3068 | 2020-05-04 |
| 1225051618 | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | Pediatrics | 4722 N 24th St Ste 150, Phoenix, AZ 85016-4860 | 2006-07-26 |
| 1255833158 | Jennifer Hann | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2018-03-06 |
| 1720408313 | Shefali Aggarwal | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2014-04-22 |
| 1821433467 | Elizabeth Rose Diaz | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2013-05-09 |
| 1700143674 | Renee Devor | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016 | 2012-04-17 |
| 1124305578 | Jeffrey H Hill Md Phc Pllc | Pediatrics | 1800 E Van Buren St, Phoenix, AZ 85006-3742 | 2011-11-14 |
| 1679779441 | Heather Anne Hanley | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2007-06-26 |
| 1427067792 | Sandra Dawn-watanabe Buttram | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-08-05 |
| 1053326637 | Paul Patrick Tafoya | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-07-30 |
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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.