Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin Grissom, AG-ACNP, FNP

Individual provider Nurse Practitioner · NPI 1609542273

Justin Grissom, AG-ACNP, FNP is a Nurse Practitioner in Colorado Springs, Colorado. Qualified in 2021, 5 years ago. Practices with Lutheran Hospital Association of the San Luis Valley, a 150-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
5
Licensed in
CO
In the registry since
2021
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

3210 Gothic Pl
Colorado Springs, CO 80917-4323
Phone: (719) 210-5633
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APN.0996720-NP (CO)

Record details

NPI number1609542273
Entity typeIndividual (Type 1)
GenderMale
Credentials AG-ACNP , FNP
Sole proprietorNo
NPI enumeratedAugust 23, 2021
Last updated in NPPESAugust 23, 2021
Certification dateAugust 23, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Lutheran Hospital Association Of The San Luis Valley — 150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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