Active NPI
Ross Grimes, PHD
- Clinical Child & Adolescent Psychologist
- Tuscaloosa, AL
National Provider Identifier
1265786347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 1779
- Practice address
- 2501 Woodland Rd
Tuscaloosa, AL 35404-5028 - Phone
- (205) 348-7236
- Fax
- (205) 348-9368
- NPI assigned
- Oct 29, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1779 | AL | Primary |
Addresses
Primary practice location
2501 Woodland Rd
Tuscaloosa, AL 35404-5028
Mailing address
PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1779 | AL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593475200000",
"number": "1265786347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55310",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352555310",
"telephone_number": "205-731-9701",
"fax_number": "205-297-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 WOODLAND RD",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354045028",
"telephone_number": "205-348-7236",
"fax_number": "205-348-9368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "ROSS",
"name_prefix": "Mr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-29",
"last_updated": "2020-06-30",
"certification_date": "2020-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "AL",
"license": "1779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuscaloosa, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.