Active NPI
Erik Grimm, DO
- Pediatrics Physician
- Las Vegas, NV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- DO3964
- Practice address
- 2650 N Tenaya Way Ste 308
Las Vegas, NV 89128-1102 - Phone
- (702) 870-2099
- Fax
- (702) 896-5347
- NPI assigned
- Mar 22, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | DO196972 | OR | |
| Pediatrics Physician | 208000000X | DO3964 | NV | Primary |
Addresses
Primary practice location
2650 N Tenaya Way Ste 308
Las Vegas, NV 89128-1102
Mailing address
6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346
Other practice location 1
16463 Boones Ferry Rd Ste 400
Lake Oswego, OR 97035-4377
Phone (503) 635-3743
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235660176 | Medicaid | NV | |
| DO3964 | Other | NV | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Touro Un Col of Osteopathic Medicine, Henderson, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6355 S Buffalo Dr
FL 3
Las Vegas, NV 89113-2133
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO3964 | NV | MD | Pediatrics Physician |
| DO196972 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermountain Medical Holdings Nevada Inc | Pediatrics | Current | Accepting new patients |
| Intermountain Medical Holdings Nevada Inc | Current | Accepting new patients | |
| Healthcare Partners Medical Group (Coats) LTD. | Pediatrics | Past | Accepting new patients |
| Olson Pediatric Clinic, LLC | Past | Accepting new patients |
Locations
2650 N Tenaya Way
Ste 308
Las Vegas, NV 89128
Phone (702) 870-2099
6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881
4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554
1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500
Interoperability endpoints
- egrimm472216@direct.lhs.org
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Henderson, NV
- NPI 1245997279
Pediatrics
-
- Home Health Agency
- Las Vegas, NV
- NPI 1689882557
-
- Pediatrics Physician
- Las Vegas, NV
- NPI 1902883341
-
- Pediatric Adolescent Medicine Physician
- Lake Oswego, OR
- NPI 1588902902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765152000000",
"number": "1235660176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6355 S BUFFALO DR FL 3",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891132133",
"telephone_number": "702-216-3346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 N TENAYA WAY STE 308",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891281102",
"telephone_number": "702-870-2099",
"fax_number": "702-896-5347"
}
],
"practiceLocations": [
{
"address_1": "16463 Boones Ferry Rd Ste 400",
"address_purpose": "LOCATION",
"city": "Lake Oswego",
"state": "OR",
"postal_code": "970354377",
"country_code": "US",
"telephone_number": "503-635-3743",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRIMM",
"first_name": "ERIK",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-22",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "DO196972",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "DO3964",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1235660176",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DO3964",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.