Individual provider Active NPI

Virginia S Grim, AUD

  • Audiologist-Hearing Aid Fitter
  • Kutztown, PA
National Provider Identifier
1407848773
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AT000006L Issued in PA
Practice address
114 S Laurel St
Kutztown, PA 19530-1509
Phone
(610) 683-6108
Fax
(610) 683-6108
NPI assigned
Aug 22, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT000006 L PA
Audiologist-Hearing Aid Fitter 237600000X AT000006L PA Primary

Addresses

Primary practice location

114 S Laurel St
Kutztown, PA 19530-1509

Mailing address

114 S Laurel St
Kutztown, PA 19530-1509
Phone (610) 683-6108

Other identifiers 1

IdentifierTypeStateIssuer
1503917MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090818000055 PA Practitioner - Qualified Audiologist 9436203072 Practice locations: Kutztown, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT000006 LPAMDAudiologist
AT000006LPAMDAudiologist-Hearing Aid Fitter

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407848773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S LAUREL ST",
            "city": "KUTZTOWN",
            "state": "PA",
            "postal_code": "195301509",
            "telephone_number": "610-683-6108",
            "fax_number": "610-683-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S LAUREL ST",
            "city": "KUTZTOWN",
            "state": "PA",
            "postal_code": "195301509",
            "telephone_number": "610-683-6108",
            "fax_number": "610-683-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIM",
        "first_name": "VIRGINIA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT000006 L",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "PA",
            "license": "AT000006L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1503917",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kutztown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.