Phillip D Grimes P C

Primary specialty

OptometristTaxonomy code 152W00000X

License

845 Issued in OK

Legal business name

PHILLIP D GRIMES P C

Doing business as

Phillip D. Grimes, O.D.

Practice address

1108 E. Highway 152
Mustang, OK 73064-5116

Phone

(405) 376-2429

Fax

(405) 376-2431

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Phillip Don Grimes, O.D.

Title

President

Phone

(405) 376-2429

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Phillip D. Grimes, O.D. Doing business as

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1386860443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 E. HIGHWAY 152",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730645116",
            "telephone_number": "405-376-2429",
            "fax_number": "405-376-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 E. HIGHWAY 152",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730645116",
            "telephone_number": "405-376-2429",
            "fax_number": "405-376-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP D GRIMES P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-376-2429",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NSC",
            "identifier": "410048647",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phillip D. Grimes, O.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Mustang, OK
• Providers in Mustang, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.