Grapevine Clinic LLC
NPI 1164731030ActiveOrganization· Family Medicine· Fort Mohave, AZ
Family Medicine in Fort Mohave, Arizona, registered in NPPES in September 2010. The authorized official on file is Kaye A. Cunningham, MD, Owner/Member. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164731030 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 27, 2010 |
| Last updated in NPPES | Sep 27, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 28326 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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