Active NPI
Jerrico Grimard
- Family Nurse Practitioner
- Colorado Springs, CO
National Provider Identifier
1316378797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0164267
- Practice address
- 3100 N Academy Blvd
Suite 211
Colorado Springs, CO 80917-5321 - Phone
- (719) 574-0384
- NPI assigned
- Dec 10, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0164267 | CO | Primary |
Addresses
Primary practice location
3100 N Academy Blvd
Suite 211
Colorado Springs, CO 80917-5321
Mailing address
4747 Bella Collina CT
Colorado Springs, CO 80906-7510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0164267 | CO | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386633600000",
"number": "1316378797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4747 BELLA COLLINA CT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809067510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 N ACADEMY BLVD",
"address_2": "SUITE 211",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809175321",
"telephone_number": "719-574-0384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMARD",
"first_name": "JERRICO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-10",
"last_updated": "2013-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "0164267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.