Active NPI
Shawn Michelle Grimm, M.A., CCC-SLP
- Speech-Language Pathologist
- Traer, IA
National Provider Identifier
1124556188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 01131
- Practice address
- 909 6TH St
Traer, IA 50675-1311 - Phone
- (319) 240-0396
- NPI assigned
- Jun 2, 2017
- Last updated
- Jun 2, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 01131 | IA | Primary |
Addresses
Primary practice location
909 6TH St
Traer, IA 50675-1311
Mailing address
404 Sherman St
Dysart, IA 52224-9710
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01131 | IA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496361600000",
"number": "1124556188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 SHERMAN ST",
"city": "DYSART",
"state": "IA",
"postal_code": "522249710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 6TH ST",
"city": "TRAER",
"state": "IA",
"postal_code": "506751311",
"telephone_number": "319-240-0396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "SHAWN",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-02",
"last_updated": "2017-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "01131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traer, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.