NPIMap

Individual provider Active NPI

John D Grimme, MD

  • Diagnostic Radiology Physician
  • Woodbridge, VA
National Provider Identifier
1093751224
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD25664 Issued in OR
Practice address
4001 Prince William Pkwy Ste 302
Woodbridge, VA 22192-7667
Phone
(703) 494-3309
Fax
(703) 321-3300
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 0101255768 VA
Diagnostic Radiology Physician 2085R0202X 25740 WV
Diagnostic Radiology Physician 2085R0202X MD25664 OR Primary

Addresses

Primary practice location

4001 Prince William Pkwy Ste 302
Woodbridge, VA 22192-7667

Mailing address

8001 Forbes PL Ste 103
Springfield, VA 22151-2205
Phone (814) 426-7319

Other identifiers 7

IdentifierTypeStateIssuer
1093751224MedicaidVA
8425142MedicaidWA
213369MedicaidOR
475804801MedicaidMD
MD1459RMedicaidAK
1093751224MedicaidWV
MD3449RMedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25740WVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Southwest Associates Past Accepting new patients
Nightrays, PA Diagnostic Radiology Past Accepting new patients
Radiology Associates, Inc. Diagnostic Radiology Past Accepting new patients
Radiology Associates PC Diagnostic Radiology Past Accepting new patients
Shenandoah Memorial Hospital, Inc. Past Accepting new patients
Pacific Northwest Radiology LLC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1093751224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 FORBES PL STE 103",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221512205",
            "telephone_number": "814-426-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 PRINCE WILLIAM PKWY STE 302",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221927667",
            "telephone_number": "703-494-3309",
            "fax_number": "703-321-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMME",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "VA",
            "license": "0101255768",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WV",
            "license": "25740",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD25664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093751224",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8425142",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213369",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "475804801",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1459R",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093751224",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD3449R",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.