Individual provider Active NPI

Michael David Grinkemeyer, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Beavercreek, OH
National Provider Identifier
1073537429
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
J0829 Issued in TX
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

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
J0829TXMDMolecular 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

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.

Verify at the official NPI Registry.