Individual provider Active NPI

Zane Calvin Grimes, PA

  • Physician Assistant
  • Fayetteville, AR
National Provider Identifier
1609235076
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PT2016-008 Issued in AR
Practice address
3336 N Futrall Dr
Fayetteville, AR 72703-4057
Phone
(479) 463-3000
NPI assigned
Feb 15, 2016
Last updated
Feb 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PT2016-008 AR Primary

Addresses

Primary practice location

3336 N Futrall Dr
Fayetteville, AR 72703-4057

Mailing address

3336 N Futrall Dr
Fayetteville, AR 72703-4057
Phone (479) 463-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20160519002070 AR Practitioner - Physician Assistant 6305135021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3336 N Futrall Dr
NW Arkansas Neuroscience Institute
Fayetteville, AR 72703-4057
Phone (479) 463-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PT2016-008ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince Apr 11, 2016 Accepting new patients
Washington Regional Medical System CurrentSince Apr 11, 2016 Accepting new patients
Washington Regional Medical System Past Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

3336 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 444-8827

Interoperability endpoints

  • Direct secure messaging: zanegrimes@wrms.allscriptsdirect.net
  • Direct secure messaging: zgrimes30402@washingtonregional.direct-ci.com

Organizations & group practices 4

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 3

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": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1609235076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 N FUTRALL DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034057",
            "telephone_number": "479-463-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 N FUTRALL DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034057",
            "telephone_number": "479-463-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "ZANE",
        "middle_name": "CALVIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PT2016-008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.