Individual provider Active NPI

Sophia Grimm, OTD, OTR/L

  • Pediatric Occupational Therapist
  • Colorado Springs, CO
National Provider Identifier
1023689965
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT.0006928 Issued in CO
Practice address
1330 Quail Lake Loop Ste 200
Colorado Springs, CO 80906-4651
Phone
(719) 540-2108
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT.0006928 CO Primary

Addresses

Primary practice location

1330 Quail Lake Loop Ste 200
Colorado Springs, CO 80906-4651

Mailing address

566 Oxbow Dr
Monument, CO 80132-6028
Phone (719) 433-9623

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL sgrimm@fscautism.com Direct

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

State licenses

LicenseStateTypeSpecialty
OT.0006928COMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1023689965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 OXBOW DR",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801326028",
            "telephone_number": "719-433-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 QUAIL LAKE LOOP STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064651",
            "telephone_number": "719-540-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "OT.0006928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sgrimm@fscautism.com",
            "affiliation": "N",
            "endpointDescription": "Personal work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1330 Quail Lake Loop Ste 200",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809064651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.