NPIMap

Individual provider Active NPI

Judith Bynum Grimm, M.D.

  • Family Medicine Physician
  • Fort Smith, AR
National Provider Identifier
1194776344
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-9002 Issued in AR
Practice address
4600 Rogers Ave
Fort Smith, AR 72903-3149
Phone
(479) 494-7443
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.14759R LA
Family Medicine Physician 207Q00000X E-9002 AR Primary

Addresses

Primary practice location

4600 Rogers Ave
Fort Smith, AR 72903-3149

Mailing address

464847 E 1098 Rd
Sallisaw, OK 74955-5320
Phone (318) 794-9937

Other identifiers 5

IdentifierTypeStateIssuer
030477389OtherLAHUMANA
030477389OtherLABEST CARE NETWORK
030477389OtherLAUNITED HEALTHCARE
1438154MedicaidLA
030477389OtherLAHUMANA MILITARY

Other names 1

  • Dr. Judith Bynum Nance Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AR, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20100218000717 LA Practitioner - Family Practice 5395889000 Reassigns benefits to 1 organization
I20170405000072 AR Practitioner - Family Practice 5395889000 Reassigns benefits to 1 organization
I20240803000076 TX Practitioner - Family Practice 5395889000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

301 S J T Stites St
Sallisaw, OK 74955-9302
Phone (918) 775-9150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Aug 4, 2024 Accepting new patients
Christus Health Central Louisiana CurrentSince Dec 14, 2009 Accepting new patients
Christus Health Central Louisiana CurrentSince Dec 14, 2009 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Medexpress Urgent Care Arkansas, P.a. CurrentSince Feb 14, 2023 Accepting new patients
Cherokee Nation CurrentSince Aug 4, 2024 Accepting new patients
Rapides Regional Physician Group Specialty Care, LLC PastSince Oct 12, 2019 Accepting new patients
Memorial Health Urgentone, Inc. Family Medicine Past Accepting new patients

Locations

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

Interoperability endpoints

  • Direct secure messaging: judith.nance.1@27404.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 7

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1194776344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464847 E 1098 RD",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749555320",
            "telephone_number": "318-794-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729033149",
            "telephone_number": "479-494-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "JUDITH",
        "middle_name": "BYNUM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.14759R",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-9002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "030477389",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEST CARE NETWORK",
            "identifier": "030477389",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "030477389",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1438154",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA MILITARY",
            "identifier": "030477389",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "NANCE",
            "middle_name": "BYNUM",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.