Individual provider Active NPI

Michael F Grimm, MD

  • Cardiovascular Disease Physician
  • Okemos, MI
National Provider Identifier
1467521930
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301052584 Issued in MI
Practice address
3413 Woods Edge
Okemos, MI 48864-6920
Phone
(517) 349-3303
Fax
(517) 349-4374
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301052584 MI Primary

Addresses

Primary practice location

3413 Woods Edge
Okemos, MI 48864-6920

Mailing address

3413 Woods Edge
Okemos, MI 48864-6920
Phone (517) 349-3303

Other identifiers 1

IdentifierTypeStateIssuer
190976110MedicaidMI

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100706000731 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Nuclear Medicine 9335103423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Nuclear Medicine
Education
St. Louis College of Physicians and Surgeons, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lansing Cardiovascular Consultants PCGroup PAC ID 9739143827, 10 clinicians

Practice addresses (Care Compare)

3413 Woods Edge
Okemos, MI 48864-5901
Phone (517) 349-3303

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301052584MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lansing Cardiovascular Consultants PC Cardiovascular Disease CurrentSince Jul 25, 1988 Accepting new patients

Locations

2380 Cedar St
Ste 100
Holt, MI 48842
Phone (517) 742-4900

3413 Woods Edge
Okemos, MI 48864
Phone (517) 349-3303

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1467521930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 WOODS EDGE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646920",
            "telephone_number": "517-349-3303",
            "fax_number": "517-349-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 WOODS EDGE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646920",
            "telephone_number": "517-349-3303",
            "fax_number": "517-349-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301052584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190976110",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.