Individual provider Active NPI

Monica Enperatris Grimaldo, FNP-C

  • Family Medicine Physician
  • Tallapoosa, GA
National Provider Identifier
1528628385
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APRN-NP226645 Issued in GA
Practice address
25 W Lyon St
Tallapoosa, GA 30176-1288
Phone
(770) 812-2800
Fax
(770) 824-2825
NPI assigned
Jun 14, 2019
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X APRN-NP226645 GA Primary

Addresses

Primary practice location

25 W Lyon St
Tallapoosa, GA 30176-1288

Mailing address

25 W Lyon St
Tallapoosa, GA 30176-1288
Phone (770) 812-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190820004014 GA Practitioner - Nurse Practitioner 1355679952 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Tallapoosa Family Healthcare CenterGroup PAC ID 0042129074, 3 clinicians

Practice addresses (Care Compare)

200 Allen Memorial Dr
Bremen, GA 30110-2012
Phone (954) 939-5000

25 W Lyon St
Tallapoosa, GA 30176-1288
Phone (770) 824-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP226645GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Em-I Medical Services, LLC CurrentSince May 1, 2021 Accepting new patients
Tanner Medical Group Inc Family Medicine CurrentSince Mar 23, 2020 Accepting new patients
TMC Tallapoosa Family Healthcare Center Family Medicine CurrentSince Sep 9, 2019 Accepting new patients
Georgia Em-I Medical Services. LLC CurrentSince May 1, 2021 Accepting new patients
TMC-Behavioral Health of West Georgia PastSince Mar 23, 2020 Accepting new patients
TMC Haralson Family Healthcare Center Family Medicine PastSince Sep 9, 2019 Accepting new patients

Locations

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

100 Greenway Blvd
Fl 2
Carrollton, GA 30117
Phone (770) 838-8710

225 Maple View Dr
Ste 102
Carrollton, GA 30117
Phone (770) 812-5678

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

25 W Lyon St
Tallapoosa, GA 30176
Phone (770) 812-2800

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1528628385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W LYON ST",
            "city": "TALLAPOOSA",
            "state": "GA",
            "postal_code": "301761288",
            "telephone_number": "770-812-2800",
            "fax_number": "770-824-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W LYON ST",
            "city": "TALLAPOOSA",
            "state": "GA",
            "postal_code": "301761288",
            "telephone_number": "770-812-2800",
            "fax_number": "770-824-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMALDO",
        "first_name": "MONICA",
        "middle_name": "ENPERATRIS",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "APRN-NP226645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallapoosa, GA

Sources for this page

Verify at the official NPI Registry.