Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Ricky D Grisson II, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1093910606

Mr. Ricky D Grisson II, MD is a Pathology in Providence, Rhode Island. Graduated from Harvard Medical School in 2007, 19 years ago. Licensed in California, Massachusetts and Rhode Island.

Years since qualifying
19
Trained at
Harvard Medical School
Licensed in
CA, MA, RI
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone: (401) 444-6779
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Pathology/Laboratory Medicine Physician (primary) Taxonomy 207ZP0105X · Licence MD15414 (RI)
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X · Licence L-232504 (MA)
Clinical Pathology/Laboratory Medicine Physician Taxonomy 207ZP0105X · Licence A121170 (CA)

Record details

NPI number1093910606
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 15, 2007
Last updated in NPPESOctober 7, 2020
Certification dateOctober 7, 2020

Medicare enrollment

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

Medicare specialtyPATHOLOGY
Medical schoolHARVARD MEDICAL SCHOOL
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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