Active NPI
Onvia Y Grimsley, CNA
- Nursing Care Agency
- Port St Lucie, FL
National Provider Identifier
1124712369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 257428
- Practice address
- 8284 Redcedar PL
Port St Lucie, FL 34952-2613 - Phone
- (772) 333-2021
- NPI assigned
- Jun 8, 2023
- Last updated
- Jun 22, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 257428 | FL | MD | Nursing 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.