Individual provider Active NPI

David B Grimm, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, OH
National Provider Identifier
1003906421
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.01721-NA Issued in OH
Practice address
500 Burlington Rd
Jackson, OH 45640-9360
Phone
(855) 446-5937
Fax
(740) 395-8519
NPI assigned
Oct 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 42699 KY
Certified Registered Nurse Anesthetist 367500000X COA.01721-NA OH Primary

Addresses

Primary practice location

500 Burlington Rd
Jackson, OH 45640-9360

Mailing address

500 Burlington Rd
Jackson, OH 45640-9360
Phone (855) 446-5937

Other practice location 1

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-7540

Other identifiers 2

IdentifierTypeStateIssuer
0752074MedicaidOH
0065977000MedicaidWV

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address David.Grimm1@17389.direct.athenahealth.com
Direct Messaging Address adena@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080506000189 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890793459 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians
Premier Anesthesia of Ohio LLCGroup PAC ID 3779714258, 123 clinicians

Practice addresses (Care Compare)

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-8575

6001 E Broad St
Columbus, OH 43213-1502
Phone (678) 690-7808

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.93 of 100Reported as group
Quality
64.42
Promoting interoperability
99
Improvement activities
40
Cost
73.2

Merit-based Incentive Payment System (MIPS)

Final score
84.27 of 100Reported as group
Quality
68.56
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
COA.01721-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Sep 20, 2021 Accepting new patients
Premier Anesthesia of Ohio LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
Ashland Anesthesia, P.S.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Interoperability endpoints

  • Direct secure messaging: david.grimm.1@17389.direct.athenahealth.com
  • Direct secure messaging: david.grimm1@17389.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1003906421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BURLINGTON RD",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456409360",
            "telephone_number": "855-446-5937",
            "fax_number": "740-395-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BURLINGTON RD",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456409360",
            "telephone_number": "855-446-5937",
            "fax_number": "740-395-8519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "272 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456019031",
            "country_code": "US",
            "telephone_number": "740-779-7540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "DAVID",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "42699",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.01721-NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0752074",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065977000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "David.Grimm1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Jackson Pike",
            "city": "Gallipolis",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456311560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena@adena.medicity.net",
            "affiliation": "N",
            "address_1": "272 Hospital Rd",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456019031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.