Jessica L Grimes, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

58569 Issued in MN

Practice address

Tri-County Health Care Ottertail Clinic
232 MN Hwy 78 North
Ottertail, MN 56571

Phone

(218) 364-6262

Fax

(218) 367-6266

NPI assigned

Jun 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Astera Health

  • Rural Health Clinic/Center
  • Wadena, MN
  • NPI 1134305162

  MN

  Medicare reassignment NPD
• Perham Hospital District

  • Chiropractor
  • Perham, MN
  • NPI 1932113768

  MN

  Medicare reassignment NPD
• Astera Health

  • Critical Access Hospital
  • Wadena, MN
  • NPI 1477545333
  NPD
• Astera Health

  • Rural Health Clinic/Center
  • Sebeka, MN
  • NPI 1831185636
  NPD
• Perham Hospital District

  • Family Medicine Physician
  • Perham, MN
  • NPI 1457631814

  Family Medicine

  NPD
• Perham Hospital District

  • Durable Medical Equipment & Medical Supplies
  • Perham, MN
  • NPI 1558630012
  NPD

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

{
    "created_epoch": "1276387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1174844286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TRI-COUNTY HEALTH CARE",
            "address_2": "415 JEFFERSON ST NORTH",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821296",
            "telephone_number": "218-631-3510",
            "fax_number": "218-631-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TRI-COUNTY HEALTH CARE OTTERTAIL CLINIC",
            "address_2": "232 MN HWY 78 NORTH",
            "city": "OTTERTAIL",
            "state": "MN",
            "postal_code": "56571",
            "telephone_number": "218-364-6262",
            "fax_number": "218-367-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-13",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125-057637",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-00541",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "58569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Astera Health
• David A Bachelder, PA-C
• Julie Domino
• Perham Hospital District
• Prescription Home Care LLC
• Sanford Clinic North
• Seip Drug LLC
• Southtown Econodrug

• All providers in Ottertail, MN
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.