Active NPI
Brian Grimm
- Home Health Aide
- Mayfield HTS, OH
National Provider Identifier
1134531478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 0095596
- Practice address
- 1598 Longwood Dr
Mayfield HTS, OH 44124-3006 - Phone
- (440) 523-0171
- NPI assigned
- May 21, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 0095596 | OH | Primary |
Addresses
Primary practice location
1598 Longwood Dr
Mayfield HTS, OH 44124-3006
Mailing address
1598 Longwood Dr
Mayfield HTS, OH 44124-3006
Phone (440) 523-0171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0095596 | Medicaid | OH |
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 |
|---|---|---|---|
| 0095596 | OH | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401235200000",
"number": "1134531478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1598 LONGWOOD DR",
"city": "MAYFIELD HTS",
"state": "OH",
"postal_code": "441243006",
"telephone_number": "440-523-0171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1598 LONGWOOD DR",
"city": "MAYFIELD HTS",
"state": "OH",
"postal_code": "441243006",
"telephone_number": "440-523-0171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-21",
"last_updated": "2014-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "0095596",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0095596",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mayfield HTS, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.