Active NPI
Michael David Grinkemeyer, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Beavercreek, OH
National Provider Identifier
1073537429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- J0829
- Practice address
- 2197 Princess Dr
Beavercreek, OH 45434-8007 - Phone
- (240) 357-5189
- NPI assigned
- Jul 27, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | J0829 | TX | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | J0829 | TX | Primary |
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | J0829 | TX |
Addresses
Primary practice location
2197 Princess Dr
Beavercreek, OH 45434-8007
Mailing address
2197 Princess Dr
Beavercreek, OH 45434-8007
Phone (240) 357-5189
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J0829 | TX | MD | Molecular Genetic Pathology (Pathology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1073537429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2197 PRINCESS DR",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454348007",
"telephone_number": "240-357-5189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2197 PRINCESS DR",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454348007",
"telephone_number": "240-357-5189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRINKEMEYER",
"first_name": "MICHAEL",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "TX",
"license": "J0829",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "TX",
"license": "J0829",
"primary": true
},
{
"code": "207ZP0007X",
"taxonomy_group": "",
"desc": "Pathology, Molecular Genetic Pathology",
"state": "TX",
"license": "J0829",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beavercreek, OH
- Greene Memorial Hospital Services, Inc. (Far Hills Medicine & Podiatry)
- Greene Memorial Hospital Services, LLC (David J Ettinger, MD)
- Harminder Grewal, MD
- Adam Grieshop, PT DPT
- Marthita Nicole Griessel
- Alanah Grisham
- Ritchie Dean Grissett
- Sherry Suzanne Grooms, NP
- Kayla Gross, LPC
- Carrie R Guay, SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.