Active NPI
Jesselyn Grimshaw
- Medical Technologist
- Des Moines, IA
National Provider Identifier
1306543103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- Practice address
- 3600 30TH St
Des Moines, IA 50310-5753 - Phone
- (515) 699-5999
- NPI assigned
- Feb 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | Primary | ||
| Technician/Technologist | 156F00000X | |||
| Clinical Medical Laboratory | 291U00000X |
Addresses
Primary practice location
3600 30TH St
Des Moines, IA 50310-5753
Mailing address
1209 Wall Ave
Des Moines, IA 50315-5066
Phone (515) 509-4533
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1306543103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1209 WALL AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503155066",
"telephone_number": "515-509-4533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 30TH ST",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503105753",
"telephone_number": "515-699-5999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMSHAW",
"first_name": "JESSELYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": null,
"license": null,
"primary": true
},
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.