Amy Taylor Grimm, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI722 Issued in ME

Practice address

253 Main St
Yarmouth, ME 04096-6800

Phone

(207) 205-5505

NPI assigned

Mar 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Amy J. Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kaleidoscope Eating Disorders and Diet Recovery Center

  • Health Service Clinic/Center
  • Portland, ME
  • NPI 1356960728
  NPD Authorized official
• Mainehealth

  • Clinic/Center
  • Portland, ME
  • NPI 1487346722
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1013032507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 FORESIDE RD",
            "city": "CUMBERLAND FORESIDE",
            "state": "ME",
            "postal_code": "041101434",
            "telephone_number": "207-205-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 MAIN ST",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966800",
            "telephone_number": "207-205-5505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75B John Roberts Rd Unit 8B",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "041063201",
            "country_code": "US",
            "telephone_number": "207-775-4151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "AMY",
        "middle_name": "TAYLOR",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "CLARK",
            "middle_name": "J.",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Good, RD, LD
• Peter T Gordon, MD
• Jana Marie Grant, OTR/L
• Allison Gray, FNP
• Greater Portland Hearing PC
• Barrett Grimnes, PA-C
• Ann Hollinger Grogan, L.C.S.W.
• Hayle Grover
• Norman J Guay III, D.O.
• Kevin Hadar

• Registered Dietitian in Yarmouth, ME
• Providers in Yarmouth, ME by specialty
• Registered Dietitian in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.