NPIMap

Individual provider Active NPI

Robert D Grimshaw, DO

  • Family Medicine Physician
  • Birch Run, MI
National Provider Identifier
1174562912
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013846 Issued in MI
Practice address
8470 Main St
Birch Run, MI 48415-9461
Phone
(989) 624-7001
Fax
(989) 624-8993
NPI assigned
Jun 6, 2006
Last updated
Mar 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101013846 MI Primary

Addresses

Primary practice location

8470 Main St
Birch Run, MI 48415-9461

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-4337

Other identifiers 1

IdentifierTypeStateIssuer
4532064MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgrimshaw18250@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000408 MI Practitioner - Family Practice 3375649882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians
Rau Physical Therapy IncGroup PAC ID 2365721339, 98 clinicians
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-4220

193 E Jefferson St
Frankenmuth, MI 48734-1935

1941 Gates St
Reese, MI 48757-9555
Phone (989) 583-5550

255 Mayer Rd
Frankenmuth, MI 48734-1358
Phone (989) 349-0016

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101013846MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc Family Medicine CurrentSince Aug 22, 2011 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients
Covenant Medical Center, Inc. CurrentSince Aug 22, 2011 Accepting new patients

Locations

8470 Main St
Birch Run, MI 48415
Phone (989) 624-2020

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1174562912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-4337",
            "fax_number": "989-583-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8470 MAIN ST",
            "city": "BIRCH RUN",
            "state": "MI",
            "postal_code": "484159461",
            "telephone_number": "989-624-7001",
            "fax_number": "989-624-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMSHAW",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4532064",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgrimshaw18250@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "8470 Main St",
            "city": "Birch Run",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484159461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birch Run, MI

Sources for this page

Verify at the official NPI Registry.