Jessica Dawn Grigoreva (NPI# 1619486693, PAC ID# 3072854314) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1619486693 |
| PAC ID by PECOS | 3072854314 |
| Professional Enrollment ID | I20190415000119 |
| Full Name | Jessica Dawn Grigoreva |
| Organization Legal Name | WESTERN PLAINS PHYSICIAN PRACTICES LLC |
| Address |
112 W Ross Blvd Suite D Dodge City KS 67801-7220 |
| Phone Number | 6203716446 |
| Gender | F |
| Graduation Year | 2019 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2264597798 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 170175 | WESTERN PLAINS MEDICAL COMPLEX |
| Address | Phone | Organization |
|---|---|---|
| 106 N Main St, Cimarron, KS 67835 | 6208554456 | WESTERN PLAINS PHYSICIAN PRACTICES LLC |
| 112 W Ross Blvd, Suite D, Dodge City, KS 67801-7220 | 6203716446 | WESTERN PLAINS PHYSICIAN PRACTICES LLC |
| Organization Legal Name | WESTERN PLAINS PHYSICIAN PRACTICES LLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samir K Shaath | Obstetrics/gynecology | Western Plains Physician Practices LLC | 112 W Ross Blvd, Suite B, Dodge City, KS 67801-7220 |
| Ajaychandra R Malladi | Internal Medicine | Western Plains Physician Practices LLC | 112 W Ross Blvd, Suite C, Dodge City, KS 67801-7220 |
| Jaclyn M Vath | Nurse Practitioner | Western Plains Physician Practices LLC | 106 N Main St, Cimarron, KS 67835 |
| Andrew J Adams | General Surgery | Western Plains Physician Practices LLC | 112 W Ross Blvd, Dodge City, KS 67801-7220 |
| Faris Sabri Azzouni | Urology | Western Plains Physician Practices LLC | 112 W Ross Blvd, Dodge City, KS 67801-7220 |
| Melanie Dawn Emily | Nurse Practitioner | Western Plains Physician Practices LLC | 3001 Ave A, Dodge City, KS 67801-2270 |
| Street Address |
112 W ROSS BLVD SUITE D |
| City | DODGE CITY |
| State | KS |
| Zip | 67801-7220 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samir K Shaath | Obstetrics/gynecology | Western Plains Physician Practices LLC | 112 W Ross Blvd, Suite B, Dodge City, KS 67801-7220 |
| Ajaychandra R Malladi | Internal Medicine | Western Plains Physician Practices LLC | 112 W Ross Blvd, Suite C, Dodge City, KS 67801-7220 |
| Andrew J Adams | General Surgery | Western Plains Physician Practices LLC | 112 W Ross Blvd, Dodge City, KS 67801-7220 |
| Faris Sabri Azzouni | Urology | Western Plains Physician Practices LLC | 112 W Ross Blvd, Dodge City, KS 67801-7220 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Raymond B Leidich | Urology | 1206 W Frontview St, Suite 203, Dodge City, KS 67801-2095 | |
| Lois A Vierthaler Kessen | Optometry | 208 W Ross Blvd, Suite A, Dodge City, KS 67801-2110 | |
| Julie Crotts | Nurse Practitioner | Cancer Center of Kansas.p.a. | 116 W Ross Blvd, Dodge City, KS 67801-2131 |
| Merrill Ray Conant | Family Medicine | Family Practice Associates of Western Kansas, LLC | 120 W Ross Blvd, Dodge City, KS 67801-2131 |
| Surendra K Verma | Radiation Oncology | Cancer Center of Kansas.p.a. | 116 W Ross Blvd, Dodge City, KS 67801-2131 |
| Mary J Schaffer | Certified Clinical Nurse Specialist (cns) | Family Practice Associates of Western Kansas, LLC | 120 W Ross Blvd, Dodge City, KS 67801-2131 |
| Samantha Jan Algrim | Family Medicine | Cancer Center of Kansas.p.a. | 116 W Ross Blvd, Dodge City, KS 67801-2131 |
| Tanya M Williams | Family Practice | Cancer Center of Kansas.p.a. | 116 W Ross Blvd, Dodge City, KS 67801-2131 |
| Jason Alan Joy | Chiropractic | 900 W Frontview, Suite 101, Dodge City, KS 67801-2233 | |
| Whitney Lea Stokes Finke | Diagnostic Radiology | Radiology Imaging Associates PC | 3001 Ave A, Dodge City, KS 67801-2270 |
| Find all physicians in zip 67801 | |||
| City | DODGE CITY |
| Zip Code | 67801 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | DODGE CITY + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jessica Dawn Grigoreva.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.