Lee Grimm, M.D., P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

12705 Issued in MS

Legal business name

LEE GRIMM, M.D., P.C.

Practice address

7580 Clarington CV
Suite 3
Southaven, MS 38671-5657

Phone

(423) 854-0001

Fax

(423) 854-0002

NPI assigned

Nov 14, 2007

Last updated

Mar 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lee M Grimm, M.D.

Title

Owner

Phone

(423) 854-0001

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leander M Grimm, M.D.

  • Surgery Physician
  • Southaven, MS
  • NPI 1598877805
  NPD (past)

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1104007558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BROWNS MILL RD",
            "address_2": "SUITE 6",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044100",
            "telephone_number": "423-854-0001",
            "fax_number": "423-854-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CLARINGTON CV",
            "address_2": "SUITE 3",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715657",
            "telephone_number": "423-854-0001",
            "fax_number": "423-854-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE GRIMM, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-854-0001",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MS",
            "license": "12705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD0811",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Lawrence, COTA/L
• Valerie Layne, RD, LD
• Ma Tessa Lolita Diaz Layugan, M.D.
• Learning to Live Again
• Stephanie Amber Ledbetter, OTR/L, MOT
• Daniel Lee, MD
• Markarius Lee
• Raven Kiara Lee, LPN
• Stephanie Denise Lee, PHARMD
• Lending Care Transportation

• Specialist in Southaven, MS
• Providers in Southaven, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.