Active NPI
Samantha Grimes, D.C.
- Chiropractor
- Fountain City, WI
National Provider Identifier
1457725285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5136-12
- Practice address
- W502 Spur LN
Fountain City, WI 54629-7208 - Phone
- (608) 687-1255
- Fax
- (608) 687-1255
- NPI assigned
- Nov 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5136-12 | WI | Primary |
Addresses
Primary practice location
W502 Spur LN
Fountain City, WI 54629-7208
Mailing address
W502 Spur LN
Fountain City, WI 54629-7208
Phone (608) 687-1255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5136-12 | WI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447718400000",
"number": "1457725285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W502 SPUR LN",
"city": "FOUNTAIN CITY",
"state": "WI",
"postal_code": "546297208",
"telephone_number": "608-687-1255",
"fax_number": "608-687-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W502 SPUR LN",
"city": "FOUNTAIN CITY",
"state": "WI",
"postal_code": "546297208",
"telephone_number": "608-687-1255",
"fax_number": "608-687-1255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "SAMANTHA",
"name_prefix": "Mrs.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-17",
"last_updated": "2015-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "5136-12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain City, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.