Individual provider Active NPI

Tonya Marie Grimme, FNP-BC

  • Family Nurse Practitioner
  • Angola, IN
National Provider Identifier
1265976286
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015831A Issued in IN
Practice address
3270 Intertech Dr
Angola, IN 46703-7325
Phone
(260) 305-2622
Fax
(260) 305-2655
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71015831A IN Primary

Addresses

Primary practice location

3270 Intertech Dr
Angola, IN 46703-7325

Mailing address

3270 Intertech Dr
Angola, IN 46703-7325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170314000853 WI Practitioner - Nurse Practitioner 0446535470
I20210503000463 TX Practitioner - Nurse Practitioner 0446535470 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71015831AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Indian Hospital Authority CurrentSince Feb 1, 2021 Accepting new patients
Cherokee Indian Hospital Authority CurrentSince Feb 1, 2021 Accepting new patients
Cherokee Indian Hospital Authority Current Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Everside Health, LLC Past Accepting new patients

Locations

68 Hospital Rd
Sylva, NC 28779
Phone (828) 586-7351

Organizations & group practices 5

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": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1265976286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 INTERTECH DR",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467037325",
            "fax_number": "603-052-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 INTERTECH DR",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467037325",
            "telephone_number": "260-305-2622",
            "fax_number": "260-305-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMME",
        "first_name": "TONYA",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015831A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.