Individual provider Active NPI

Chassidy Erin Grimes

  • Colon & Rectal Surgery Physician
  • Chicago, IL
National Provider Identifier
1528527678
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME181333 Issued in FL
Practice address
1750 W Harrison St
Chicago, IL 60612-3825
Phone
(312) 942-7100
NPI assigned
Mar 18, 2019
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Colon & Rectal Surgery Physician 208C00000X ME181333 FL Primary

Addresses

Primary practice location

1750 W Harrison St
Chicago, IL 60612-3825

Mailing address

770 W Granada Blvd Ste 101
Ormond Beach, FL 32174-5179
Phone (386) 231-4519

Other practice location 1

400 Clyde Morris Blvd Ste A
Ormond Beach, FL 32174-8172
Phone (386) 231-6500

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ME181333FLMDColon & Rectal Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1528527678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 W GRANADA BLVD STE 101",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745179",
            "telephone_number": "386-231-4519",
            "fax_number": "386-368-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123825",
            "telephone_number": "312-942-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Clyde Morris Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321748172",
            "country_code": "US",
            "telephone_number": "386-231-6500",
            "fax_number": "386-231-6541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "CHASSIDY",
        "middle_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME181333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.