Matthew R Grimm, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

021247 Issued in LA

Practice address

920 Avenue B
Marrero, LA 70072-3112

Phone

(504) 349-6804

Fax

(504) 349-6844

NPI assigned

May 10, 2006

Last updated

Aug 9, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1407806748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 AVENUE B",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723112",
            "telephone_number": "504-349-6804",
            "fax_number": "504-349-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 AVENUE B",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723112",
            "telephone_number": "504-349-6804",
            "fax_number": "504-349-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "021247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "5B353",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "1792217",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL",
            "identifier": "200023859",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CK4990",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1974391",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Gregg
• Clementine Griffin, LMSW
• William Griffin, PHARMD
• Jake Andrew Grill, DDS
• Alexis Grimes
• Thomas H Grimstad, MD
• Samantha Jordan Gros
• Robert Gruner, MD
• Lauren Claire Guarino, G.S.W.
• Joseph Guarnieri, M.D.

• Orthopaedic Surgery Physician in Marrero, LA
• Providers in Marrero, LA by specialty
• Orthopaedic Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.