Dominique Shanicia Grisby, PMHNP in Monroe, LA

Dominique Shanicia Grisby, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Monroe, Louisiana. She graduated from nursing school in 2024 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Homer Memorial Hospital, Senior Psychcare Of Louisiana, Llc and her current practice location is 622 Riverside Dr, Monroe, Louisiana. You can reach out to her office (for appointments etc.) via phone at (318) 398-0945.

Dominique Shanicia Grisby is licensed to practice in Louisiana (license number 237531) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1417781030.

Contact Information

	Dominique Shanicia Grisby, PMHNP
	622 Riverside Dr, Monroe, LA 71201-6211
	(318) 398-0945
	Not Available

Map and Direction

Provider's Profile

Full Name	Dominique Shanicia Grisby
Gender	Female
Speciality	Nurse Practitioner
Experience	2 Years
Location	622 Riverside Dr, Monroe, Louisiana
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dominique Shanicia Grisby graduated from nursing school in 2024

NPI Data:

NPI Number: 1417781030
Provider Enumeration Date: 08/27/2024
Last Update Date: 04/28/2026

Medicare PECOS Information:

PECOS PAC ID: 0244752293
Enrollment ID: I20250319001159

Medical Identifiers

Medical identifiers for Dominique Shanicia Grisby such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417781030	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	237531 (Louisiana)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Homer Memorial Hospital	1456322692	22
Senior Psychcare Of Louisiana, Llc	0648651539	8

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dominique Shanicia Grisby allows following entities to bill medicare on her behalf.

Entity Name	Homer Memorial Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609066646 PECOS PAC ID: 1456322692 Enrollment ID: O20040803000291

Entity Name	Senior Psychcare Of Louisiana, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821749789 PECOS PAC ID: 0648651539 Enrollment ID: O20220725000773

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dominique Shanicia Grisby is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dominique Shanicia Grisby, PMHNP 201 Rue Beauregard Ste 202, Lafayette, LA 70508-3251 Ph: (713) 850-0049	Dominique Shanicia Grisby, PMHNP 622 Riverside Dr, Monroe, LA 71201-6211 Ph: (318) 398-0945

Reviews and Comments

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Miss Matilda Elliott Stephens, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3400 Medical Park Dr Ste B, Monroe, LA 71203 Phone: 318-387-6803 Fax: 318-387-6874

Dominique Shanicia Grisby, PMHNP - Medicare Nurse Practitioner in Monroe, LA