NPIMap

Individual provider Active NPI

Georgina Giselle Grimm, FNP

  • Family Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1104367739
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95006100 Issued in CA
Practice address
9925 International Blvd
#5
Oakland, CA 94603-2558
Phone
(510) 777-1177
Fax
(510) 550-2644
NPI assigned
Mar 15, 2017
Last updated
Mar 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95006100 CA Primary

Addresses

Primary practice location

9925 International Blvd
#5
Oakland, CA 94603-2558

Mailing address

5018 Shafter Ave
Oakland, CA 94609-2221
Phone (510) 388-3261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170727001553 CA Practitioner - Nurse Practitioner 5799055596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1150 Foster Ave
Arcata, CA 95521-5986
Phone (707) 826-8610

2200 Tydd St
Eureka, CA 95501-1284
Phone (707) 441-1624

2426 Buhne St
Eureka, CA 95501-3207
Phone (707) 442-4038

3750 Rohnerville Rd
Fortuna, CA 95540-3118
Phone (707) 725-6101

38883 Hwy 299
Willow Creek, CA 95573-0726
Phone (530) 629-3111

785 18TH St
Arcata, CA 95521-5683
Phone (707) 822-2481

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Sep 7, 2019 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Sep 7, 2019 Accepting new patients

Locations

1275 8th St
Arcata, CA 95521

770 10th St
Arcata, CA 95521
Phone (707) 826-8610

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636

2200 Tydd St
Eureka, CA 95501
Phone (707) 441-1624

3306 Renner Dr
Fortuna, CA 95540
Phone (707) 725-4477

1644 Central Ave
McKinleyville, CA 95519
Phone (707) 839-3068

Interoperability endpoints

  • Direct secure messaging: ggrimm251301@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1104367739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5018 SHAFTER AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092221",
            "telephone_number": "510-388-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 INTERNATIONAL BLVD",
            "address_2": "#5",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946032558",
            "telephone_number": "510-777-1177",
            "fax_number": "510-550-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "GEORGINA",
        "middle_name": "GISELLE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.