NPIMap

Individual provider Active NPI

Johannes Fredrik Grimmer, MD

  • Pediatric Otolaryngology Physician
  • Salt Lake City, UT
National Provider Identifier
1477643070
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
5856707-1205 Issued in UT
Practice address
100 N Medical Dr
Suite 4500
Salt Lake City, UT 84113-1103
Phone
(801) 662-5671
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 5856707-1205 UT Primary

Addresses

Primary practice location

100 N Medical Dr
Suite 4500
Salt Lake City, UT 84113-1103

Mailing address

PO Box 581094
Salt Lake City, UT 84158-1094
Phone (801) 213-3800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fgrimmer49591@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050427001019 UT Practitioner - Pediatric MedicinePractitioner - Otolaryngology 0143269365 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Dec 2, 2020 Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 15, 2017 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 15, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince Dec 2, 2020 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
University of Utah Pediatric Services Past Accepting new patients

Locations

2250 N Miller Campus Dr
Lehi, UT 84048
Phone (385) 531-1000

127 S 500 E
Ste 200
Salt Lake City, UT 84102

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Interoperability endpoints

  • Direct secure messaging: fgrimmer49591@direct.med.utah.edu

Organizations & group practices 10

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1477643070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581094",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841581094",
            "telephone_number": "801-213-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "address_2": "SUITE 4500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMMER",
        "first_name": "JOHANNES",
        "middle_name": "FREDRIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "UT",
            "license": "5856707-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fgrimmer49591@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.