Active NPI
Tiffany Grimm, PHARM D
- Pharmacist
- Manassas, VA
National Provider Identifier
1225318942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202209367
- Practice address
- 6400 Hoadly Rd
Manassas, VA 20112-3436 - Phone
- (703) 259-6396
- NPI assigned
- Aug 25, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202209367 | VA | Primary |
Addresses
Primary practice location
6400 Hoadly Rd
Manassas, VA 20112-3436
Mailing address
6400 Hoadly Rd
Manassas, VA 20112-3436
Phone (703) 259-6390
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202209367 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335312000000",
"number": "1225318942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 HOADLY RD",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201123436",
"telephone_number": "703-259-6390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 HOADLY RD",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201123436",
"telephone_number": "703-259-6396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "TIFFANY",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-25",
"last_updated": "2012-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202209367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.