Abigale Grimm, MCD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8594 Issued in TN

Practice address

2214 E Fairview Ave
Johnson City, TN 37601-2860

Phone

(423) 928-6464

NPI assigned

Oct 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Fairview Therapy

  • Early Intervention Provider Agency
  • Johnson City, TN
  • NPI 1831774637

  Speech-Language Pathologist

  NPD
• Mini Miracles Pediatric Therapy, PLLC

  • Early Intervention Provider Agency
  • Johnson City, TN
  • NPI 1477991560
  NPD

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1013516004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 APPLETREE CT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376153072",
            "telephone_number": "901-326-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 E FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012860",
            "telephone_number": "423-928-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1751 Dancy Blvd",
            "address_purpose": "LOCATION",
            "city": "Horn Lake",
            "state": "MS",
            "postal_code": "386371916",
            "country_code": "US",
            "telephone_number": "901-292-5313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7579 Wisteria Dr",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386546982",
            "country_code": "US",
            "telephone_number": "615-717-7471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "ABIGALE",
        "name_prefix": "Mrs.",
        "credential": "MCD, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S-4658",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "8594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber N Griffin, LMSW
• Kasi Griffin, MD
• Taylor Griffin, COTA/L
• Sumalee Griffith
• Steven D Grijalva, MD
• Melissa L Grissinger, FNP
• Dana Alan Grist, O.D.
• Eric J Groen, DO
• Violetta Vadimovna Gromova
• Ashley Gross, FNP

• Speech-Language Pathologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.