Individual provider Active NPI

Kendra M Grimes, ANP, GNP

  • Gerontology Nurse Practitioner
  • Dedham, MA
National Provider Identifier
1346517067
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2271019 Issued in MA
Practice address
7000 Great Meadow Rd
Dedham, MA 02026-4090
Phone
(781) 234-9700
NPI assigned
Nov 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2271019 MA
Gerontology Nurse Practitioner 363LG0600X 2271019 MA Primary

Addresses

Primary practice location

7000 Great Meadow Rd
Dedham, MA 02026-4090

Mailing address

7000 Great Meadow Rd
Dedham, MA 02026-4090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000021 MA Practitioner - Nurse Practitioner 3678740172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hebrew Rehabilitation CenterGroup PAC ID 6608855119, 49 clinicians

Practice addresses (Care Compare)

100 Centre St
Brookline, MA 02446-2805
Phone (617) 363-8010

1200 Centre St
Roslindale, MA 02131-1000
Phone (617) 363-8010

7000 Great Meadow Rd
Dedham, MA 02026-4090
Phone (617) 363-8010

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Hebrew Rehabilitation Center Long-term care hospital, Boston, MA, CCN 222007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2271019MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hebrew Rehabilitation Center CurrentSince Dec 1, 2011 Accepting new patients
Hebrew Rehabilitation Center CurrentSince Dec 1, 2011 Accepting new patients

Locations

7000 Great Meadow Rd
Dedham, MA 02026
Phone (781) 234-9600

1200 Centre St
Roslindale, MA 02131
Phone (617) 363-8000

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1346517067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 GREAT MEADOW RD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 GREAT MEADOW RD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264090",
            "telephone_number": "781-234-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "KENDRA",
        "middle_name": "M",
        "credential": "ANP, GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "2271019",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "2271019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.