Active NPI
Johanna Marie Grimes, LM
- Midwife
- Benzonia, MI
National Provider Identifier
1619694395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 7601000102
- Practice address
- 5885 Frankfort Hwy
Benzonia, MI 49616-9525 - Phone
- (517) 648-4102
- Fax
- (231) 284-2030
- NPI assigned
- Oct 24, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 7601000102 | MI | Primary |
Addresses
Primary practice location
5885 Frankfort Hwy
Benzonia, MI 49616-9525
Mailing address
9742 Narrow Gauge Rd
Beulah, MI 49617-9770
Phone (517) 648-4102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7601000102 | MI | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1619694395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9742 NARROW GAUGE RD",
"city": "BEULAH",
"state": "MI",
"postal_code": "496179770",
"telephone_number": "517-648-4102",
"fax_number": "231-284-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5885 FRANKFORT HWY",
"city": "BENZONIA",
"state": "MI",
"postal_code": "496169525",
"telephone_number": "517-648-4102",
"fax_number": "231-284-2030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "JOHANNA",
"middle_name": "MARIE",
"credential": "LM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-24",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "MI",
"license": "7601000102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benzonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.