Teresa G Grimes, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

994-023 Issued in WI

Practice address

132 Hospital Dr
Watertown, WI 53098-3304

Phone

(920) 261-2020

Fax

(920) 261-0457

NPI assigned

Jan 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Resources Associates IncGroup PAC ID 5991773699, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Family Resources Associates Inc

  • Mental Health Counselor
  • Watertown, WI
  • NPI 1831202621
  Medicare reassignment Care Compare group
• Family Resources Associates Inc

  • Mental Health Counselor
  • Jefferson, WI
  • NPI 1497960645
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619024494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6480 SHOREWOOD MEADOWS DR",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535519730",
            "telephone_number": "920-648-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 HOSPITAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983304",
            "telephone_number": "920-261-2020",
            "fax_number": "920-261-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "TERESA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "994-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41958600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody Denise Goodle
• Margaret Mary Gora, OTR
• Greg Thomas Graglia, DPM
• Michael A Grajewski, MD
• Frederick C Gremmels, D.O.
• Carmen Marie Groehler, REGISTERED NURSE
• David J Groh, DDS
• Amanda Grosnick, CD, RD
• Philip M Grosnick, D.D.S.
• Cynthia Sue Grudzinski, PT

• Physician Assistant in Watertown, WI
• Providers in Watertown, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.