Individual provider Active NPI

Christopher Scott Michael Grimes, PSY.D.

  • Clinical Psychologist
  • Independence, MO
National Provider Identifier
1629176706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2006029905 Issued in MO
Practice address
3031 M 291 Frontage Rd
Suite 200
Independence, MO 64057-2334
Phone
(816) 373-9240
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2006029905 MO Primary

Addresses

Primary practice location

3031 M 291 Frontage Rd
Suite 200
Independence, MO 64057-2334

Mailing address

733 N Sioux Ave
Independence, MO 64056-2142
Phone (816) 796-7929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061222000141 MO Practitioner - Clinical Psychologist 4385644335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1129 Macklind Ave
Saint Louis, MO 63110-1440
Phone 3145340200415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
St. Louis Behavioral Medicine Institute Inc CurrentSince Jan 1, 2009 Accepting new patients
St. Louis Behavioral Medicine Institute Inc CurrentSince Jan 1, 2009 Accepting new patients
Brian a Fidler Clinical PastSince Sep 26, 2013 Accepting new patients
John T Bopp PC Clinical Past Accepting new patients
BPH LLC Past Accepting new patients
Diakonos Inc Clinical PastSince Mar 12, 2007 Accepting new patients

Locations

1129 Macklind Ave
Saint Louis, MO 63110
Phone (314) 534-0200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629176706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 N SIOUX AVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640562142",
            "telephone_number": "816-796-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 M 291 FRONTAGE RD",
            "address_2": "SUITE 200",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572334",
            "telephone_number": "816-373-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "CHRISTOPHER",
        "middle_name": "SCOTT MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2006029905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.