Jeffrey Grimm, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

201050059NP Issued in OR

Practice address

1741 NW 24TH Ave
Portland, OR 97210

Phone

(971) 770-1655

Fax

(844) 364-2677

NPI assigned

May 7, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: biolounge@org14.direct.charmhealth.com

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.

• Grain Integrative Health, LLC

  • Naturopath
  • Portland, OR
  • NPI 1528471349
  NPD (past)
• Sr Clinic

  • Acupuncturist
  • Portland, OR
  • NPI 1043045388
  NPD (past)

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1497073936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 NW 24TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "971-770-1655",
            "fax_number": "844-364-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 NW 24TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "971-770-1655",
            "fax_number": "844-364-2677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1759 NW 24TH AVE",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97210",
            "country_code": "US",
            "telephone_number": "971-770-1655",
            "fax_number": "844-364-2677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-07",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201050059NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Grimes
• Amy Grimm
• Anna Kathleen Grimm, NP
• Bonnie Grimm
• Candace Grimm
• Jesse Coy Grimmett
• Mariel Bay Grimord-Isham, MSW, LCSW
• Amanda Grimshaw
• Molly Leora Grimshaw
• Alina Grimsted, LCSW

• Adult Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.