Grapevine Clinic LLC
NPI 1164731030 · Family Medicine Physician · Fort Mohave, AZ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Grapevine Clinic LLC is a Family Medicine Physician organization in Fort Mohave, AZ (NPI 1164731030).
Provider details
- NPI number
- 1164731030
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kaye Cunningham, Owner/Member(928) 788-6060
- License
- 28326 (AZ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-09-27
- Last updated
- 2010-09-27
Frequently asked questions
- What is Grapevine Clinic LLC's NPI number?
- Grapevine Clinic LLC's National Provider Identifier (NPI) is 1164731030, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grapevine Clinic LLC?
- Grapevine Clinic LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Grapevine Clinic LLC located?
- Grapevine Clinic LLC's practice location on file with NPPES is 5300 S Highway 95, Fort Mohave, AZ 86426-9251.
- What is Grapevine Clinic LLC's phone number?
- The practice phone number listed in the NPPES registry for Grapevine Clinic LLC is (928) 788-6060.
- Does Grapevine Clinic LLC accept Medicare?
- Grapevine Clinic LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Grapevine Clinic LLC?
- The authorized official listed on Grapevine Clinic LLC's NPPES record is Kaye Cunningham, Owner/Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grapevine Clinic LLC's NPI active?
- Yes — Grapevine Clinic LLC's NPI (1164731030) is active in the NPPES registry as of the last update on 2010-09-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.