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ERIC ALEXANDER GRISHAM MD
NPI 1871172593
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Active since April 08, 2021PECOS Enrolled
1402 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 617-2408 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 4, 2025, Apr 8, 2021 (2 updates tracked since 2021).

About Eric Alexander Grisham Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERIC ALEXANDER GRISHAM MD (NPI 1871172593) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871172593
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameERIC ALEXANDER GRISHAMCredential: MD
Location Address1402 S GRAND BLVDSaint Louis, MO 63104-1004
Mailing Address1402 S Grand BlvdSaint Louis, MO 63104-1004 · (314) 617-2408
Phone(314) 617-2408
Sole ProprietorYes
Enumeration DateApril 8, 2021
Last NPPES UpdateApril 4, 20252 updates tracked since enumeration
NPPES CertifiedApril 4, 2025
✔ NPI 1871172593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1402 S GRAND BLVD, Saint Louis, MO 63104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eric Alexander Grisham Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HALA YAMOUT M.D.
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD, M260
SAINT LOUIS, MO 63104
St. Louis City (314) 977-9853
VICTORIA M WITTGEN
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-9870
ADAM BALES D.O.
Anesthesiology
1402 S GRAND BLVD, M260
SAINT LOUIS, MO 63104
St. Louis City (314) 977-9853
ALLISON NICOLE PODSEDNIK GARDNER MD
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-3811
DR. KATHERINE JASKOWIAK ROBBINS MD
Pathology (Anatomic Pathology & Clinical Pathology)
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-4547
DR. VIVIAN MAI HATHUC D.O.
Pathology (Anatomic Pathology & Clinical Pathology)
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-4547
TERRY J BUJNAK JR. DO
Orthopaedic Surgery
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-3375
MS. FRANCESCA VACCA
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-8694

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eric Grisham's NPI number?

The NPI number for Eric Grisham is 1871172593. It was assigned to this individual provider in the NPPES registry on April 8, 2021.

Where is Eric Grisham located?

Eric Grisham practices at 1402 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 617-2408.

What is Eric Grisham's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Eric Grisham enrolled in Medicare?

Yes. Eric Grisham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Eric Grisham was last updated on April 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.