Individual provider Active NPI

Jeffery Robert Grimes

  • Internal Medicine Physician
  • Charleston, SC
National Provider Identifier
1194790881
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD29477 Issued in SC
Practice address
109 Bee St
Charleston, SC 29401-5703
Phone
(843) 577-5011
NPI assigned
Feb 17, 2006
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38962 NC
Internal Medicine Physician 207R00000X MD29477 SC Primary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 38962 NC
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 38962 NC

Addresses

Primary practice location

109 Bee St
Charleston, SC 29401-5703

Mailing address

3725 Seabrook Island Rd
Johns Island, SC 29455-6055

Other identifiers 2

IdentifierTypeStateIssuer
1194790881MedicaidNC
37653OtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Hospital Rd
Cherokee, NC 28719-9253

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD29477SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC Past Accepting new patients
Highland Emergency Physicians, PLLC Past Accepting new patients
Emergency Coverage, LLC Internal Medicine Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Haywood Emergency Physicians, Inc. Past Accepting new patients

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1194790881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 SEABROOK ISLAND RD",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294556055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-577-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "JEFFERY",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "38962",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "MD29477",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NC",
            "license": "38962",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "38962",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194790881",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37653",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.