Ruby Ann Grimm

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

21472 Issued in NC

Legal business name

RUBY ANN GRIMM

Practice address

738 Bryant Street
Statesville, NC 28677-4189

Phone

(704) 873-2219

Fax

(704) 873-1379

NPI assigned

Nov 20, 2006

Last updated

May 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Donna L Scire

Title

Office Manager

Phone

(704) 873-2219

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1295809416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 BRYANT STREET",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774189",
            "telephone_number": "704-873-2210",
            "fax_number": "704-873-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 BRYANT STREET",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774189",
            "telephone_number": "704-873-2219",
            "fax_number": "704-873-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBY ANN GRIMM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "SCIRE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-873-2219",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "21472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8937657",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hematology & Oncology Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Hematology & Oncology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.