Individual provider Active NPI

Cynthia Grimston, PA-C

  • Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1467940817
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008678 Issued in MI
Practice address
207 Fletcher St
Ann Arbor, MI 48109-1050
Phone
(734) 764-8320
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008678 MI Primary

Addresses

Primary practice location

207 Fletcher St
Ann Arbor, MI 48109-1050

Mailing address

207 Fletcher St
Ann Arbor, MI 48109-1050
Phone (734) 764-8320

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618001718 MI Practitioner - Physician Assistant 8224383112 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601008678MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cgrimston216054@epic00.shdirect.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1467940817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 FLETCHER ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091050",
            "telephone_number": "734-764-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 FLETCHER ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091050",
            "telephone_number": "734-764-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMSTON",
        "first_name": "CYNTHIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.