Individual provider Active NPI

Kathy A Grimwood, MA

  • Audiologist
  • Eugene, OR
National Provider Identifier
1255375127
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
21346 Issued in OR
Practice address
330 S Garden Way
Suite 300
Eugene, OR 97401-8176
Phone
(541) 334-3370
Fax
(541) 334-3372
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 21346 OR Primary

Addresses

Primary practice location

330 S Garden Way
Suite 300
Eugene, OR 97401-8176

Mailing address

PO Box 1648
Eugene, OR 97440-1648
Phone (541) 334-3370

Other identifiers 1

IdentifierTypeStateIssuer
119060MedicaidOR

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
21346ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Community Medical Group LLC Past Accepting new patients
Oregon Healthcare Resources, LLC 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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1255375127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974401648",
            "telephone_number": "541-334-3370",
            "fax_number": "541-334-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S GARDEN WAY",
            "address_2": "SUITE 300",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018176",
            "telephone_number": "541-334-3370",
            "fax_number": "541-334-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMWOOD",
        "first_name": "KATHY",
        "middle_name": "A",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "21346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119060",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.