Active NPI
Arthur Grimball, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Jackson, TN
National Provider Identifier
1023067972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- MD0000020743
- Practice address
- 329 Coatsland Dr
Jackson, TN 38301-3912 - Phone
- (731) 424-5080
- NPI assigned
- May 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MD0000020743 | TN | Primary |
Addresses
Primary practice location
329 Coatsland Dr
Jackson, TN 38301-3912
Mailing address
329 Coatsland Dr
Jackson, TN 38301-3912
Phone (731) 424-5080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3054967 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20743 | NC | MD | Pharmacist |
| MD0000020743 | TN | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| 20743 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiothoracic Surgery Center, P.L.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Jackson, TN
- NPI 1154370948
Thoracic Surgery (Cardiothoracic Vascular Surgery)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265760000000",
"number": "1023067972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 COATSLAND DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013912",
"telephone_number": "731-424-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "329 COATSLAND DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013912",
"telephone_number": "731-424-5080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMBALL",
"first_name": "ARTHUR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2010-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "TN",
"license": "MD0000020743",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3054967",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.