Individual provider Active NPI

Onvia Y Grimsley, CNA

  • Nursing Care Agency
  • Port St Lucie, FL
National Provider Identifier
1124712369
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
257428 Issued in FL
Practice address
8284 Redcedar PL
Port St Lucie, FL 34952-2613
Phone
(772) 333-2021
NPI assigned
Jun 8, 2023
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 257428 FL Primary
Adult Care Home Facility 311ZA0620X NU

Addresses

Primary practice location

8284 Redcedar PL
Port St Lucie, FL 34952-2613

Mailing address

8284 Redcedar PL
Port St Lucie, FL 34952-2613
Phone (772) 227-0157

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

State licenses

LicenseStateTypeSpecialty
257428FLMDNursing Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1124712369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8284 REDCEDAR PL",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522613",
            "telephone_number": "772-227-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8284 REDCEDAR PL",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522613",
            "telephone_number": "772-333-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMSLEY",
        "first_name": "ONVIA",
        "middle_name": "Y",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "257428",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.