Ruby Ann Grimm, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

21472 Issued in NC

Practice address

738 Bryant St
Statesville, NC 28677-4189

Phone

(704) 873-2219

Fax

(704) 873-1379

NPI assigned

Nov 2, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: rubygrimm@imhi.allscriptsdirect.net

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1154312841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896199",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896199",
            "telephone_number": "704-873-2219",
            "fax_number": "704-873-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 BRYANT ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774189",
            "telephone_number": "704-873-2219",
            "fax_number": "704-873-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "RUBY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NC",
            "license": "21472",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "21472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8937657",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory J. Kuchtjak, D.M.D., P.a.
• Brittany Nicole Griffin, FNP
• Brittney Elizabeth Griffin, RPH
• Natalie Sterling Griffith
• Joel Kenneth Grimberg, PHARMD, RPH
• Constance Ellen Grundmeyer, R.N.
• Linda L Guentner, RN
• Karen Marie Gunderson, PA-C
• Courtney Lynn Haddock, FNP-C
• Meredith Haley

• Hematology & Oncology Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Hematology & Oncology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.