Individual provider Active NPI

Kristen Alexis Grimes, MS, RD, LD

  • Registered Dietitian
  • Scarborough, ME
National Provider Identifier
1144562638
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI1130 Issued in ME
Practice address
175 US Route 1
Scarborough, ME 04074-9048
Phone
(207) 396-7700
NPI assigned
Mar 22, 2013
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI1130 ME Primary

Addresses

Primary practice location

175 US Route 1
Scarborough, ME 04074-9048

Mailing address

20 Ephraim Tyler Way
Kennebunk, ME 04043-7361
Phone (814) 242-5812

Other practice location 1

1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 283-7239

Other names 1

  • Miss Kristen Alexis Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180212000894 ME Practitioner - Registered Dietitian Or Nutrition Professional 4486914504 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DI1130MEMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 16, 2018 Accepting new patients
Maine Medical Partners CurrentSince Dec 17, 2017 Accepting new patients
Maine Medical Partners Dietitian, Registered CurrentSince Dec 17, 2017 Accepting new patients
Mainehealth CurrentSince Sep 16, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Past Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

175 US Route 1
Scarborough, ME 04074
Phone (207) 396-7700

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

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.

NPI Registry JSON

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1144562638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 EPHRAIM TYLER WAY",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040437361",
            "telephone_number": "814-242-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749048",
            "telephone_number": "207-396-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Biddeford",
            "state": "ME",
            "postal_code": "040059422",
            "country_code": "US",
            "telephone_number": "207-283-7239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "KRISTEN",
        "middle_name": "ALEXIS",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI1130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "THOMAS",
            "middle_name": "ALEXIS",
            "prefix": "MISS",
            "credential": "MS, RD, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.