Individual provider Active NPI

Erik Grimm, DO

  • Pediatrics Physician
  • Las Vegas, NV
National Provider Identifier
1235660176
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO3964 Issued in NV
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

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1235660176MedicaidNV
DO3964OtherNVLICENSE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251026000448 NV Practitioner - Pediatric Medicine 3375813058 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
DO3964NVMDPediatrics Physician
DO196972ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc Pediatrics CurrentSince Dec 8, 2025 Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Dec 8, 2025 Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Pediatrics Past Accepting new patients
Olson Pediatric Clinic, LLC PastSince Jun 28, 2020 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.