Erica Marie Grimm, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036176517 Issued in IL

Practice address

3412 Office Park Dr
Marion, IL 62959-6477

Phone

(618) 993-0404

Fax

(618) 993-1717

NPI assigned

Apr 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erica Marie White Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11869/brand/1/csg/1/fhir/r4
• Direct secure messaging: erica.grimm.1@11869.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Group LLC

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1023582038

  Pediatrics

  NPD (past)
• Pediatric Group LLC

  • Rural Health Clinic/Center
  • Marion, IL
  • NPI 1114129970

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1346746419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21819 ENYENHAUSEN RD",
            "city": "CREAL SPRINGS",
            "state": "IL",
            "postal_code": "629222423",
            "telephone_number": "315-708-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 OFFICE PARK DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596477",
            "telephone_number": "618-993-0404",
            "fax_number": "618-993-1717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4430 Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "654739098",
            "country_code": "US",
            "telephone_number": "573-596-1766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "ERICA",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036176517",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "2105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "WHITE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cortney M Grassl
• Mary Louise Gray
• Kevin Green
• Toneka Grigsby-Green, BSW
• Stephanie Grigsby, MSW
• Charlotte C Grove, LCSW
• Xennia Gruszczyk
• Rodney Christian Guiseppi, M.D.
• Ryan August Gullett, D.C
• Jalynn Gunn

• Pediatrics Physician in Marion, IL
• Providers in Marion, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.

Verify at the official NPI Registry.