Individual provider Active NPI

Brittany Nicole Grimes, FNP-C

  • Nurse Practitioner
  • Fort Walton Beach, FL
National Provider Identifier
1013434570
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-9322736 Issued in FL
Practice address
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone
(850) 863-8100
Fax
(850) 243-0594
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN-9322736 FL Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Mailing address

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8100

Other identifiers 3

IdentifierTypeStateIssuer
022573100MedicaidFL
NZ902OtherFLMEDICARE - FL
EI8WTOtherFLBCBS FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171201000514 FL Practitioner - Nurse Practitioner 0143587048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerald Coast Infectious Diseases Medical Group, P.a.Group PAC ID 5092753772, 35 clinicians

Practice addresses (Care Compare)

917 Mar Walt Dr
Fort Walton Beach, FL 32547-6651
Phone (850) 862-3979

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-9322736FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
White-Wilson Medical Center PA CurrentSince Apr 12, 2023 Accepting new patients
Emerald Coast Infectious Diseases Medical Group, P.a. Nurse Practitioner CurrentSince Jan 1, 2026 Accepting new patients
Emerald Coast Infectious Diseases Medical Group, PA CurrentSince Jan 1, 2026 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

917 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 862-3979

1005 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-8100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCDJDD/Endpoint/DCDJDD
  • Direct secure messaging: brittanygrimes@ocfl.allscriptsdirect.net

Organizations & group practices 4

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

Hospital & facility affiliations 3

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1013434570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8100",
            "fax_number": "850-863-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-863-8100",
            "fax_number": "850-243-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "BRITTANY",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN-9322736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022573100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - FL",
            "identifier": "NZ902",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "EI8WT",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.