Individual provider Active NPI

Michelle Grimes, FNP

  • Family Nurse Practitioner
  • Florissant, MO
National Provider Identifier
1528503380
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017003913 Issued in MO
Practice address
472 N Highway 67 St
Florissant, MO 63031-5102
Phone
(314) 343-5061
NPI assigned
Jan 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 109025 MO
Family Nurse Practitioner 363LF0000X 2017003913 MO Primary

Addresses

Primary practice location

472 N Highway 67 St
Florissant, MO 63031-5102

Mailing address

PO Box 740019
Atlanta, GA 30374-0019
Phone (312) 733-9730

Other practice location 1

4919 Jamestowne Ridge Ct
Black Jack, MO 63033-4554
Phone (636) 789-1499

Other practice location 2

1551 Wall St Ste 110
Saint Charles, MO 63303-3540
Phone (636) 493-9601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20170308002266 MO Practitioner - Nurse Practitioner 8224312350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group of Missouri LLCGroup PAC ID 7315340213, 25 clinicians

Practice addresses (Care Compare)

472 N Hwy 67 St
Florissant, MO 63031-5102
Phone (314) 967-1465

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Missouri, LLC Family CurrentSince Oct 7, 2024 Accepting new patients

Locations

472 N Highway 67 St
Florissant, MO 63031
Phone (314) 343-5061

16659 E 23rd St S
Independence, MO 64055
Phone (816) 688-6000

3843 Gravois Ave
Saint Louis, MO 63116
Phone (314) 888-0981

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 2

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": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1528503380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740019",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740019",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 N HIGHWAY 67 ST",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630315102",
            "telephone_number": "314-343-5061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4919 Jamestowne Ridge Ct",
            "address_purpose": "LOCATION",
            "city": "Black Jack",
            "state": "MO",
            "postal_code": "630334554",
            "country_code": "US",
            "telephone_number": "636-789-1499",
            "fax_number": "314-293-6748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1551 Wall St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633033540",
            "country_code": "US",
            "telephone_number": "636-493-9601",
            "fax_number": "314-293-6748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "109025",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017003913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.