Regina Leah Grimm, APRN
Individual provider Active NPI Nurse Practitioner · Staffordsville, KY
NPI 1629927561 · NPPES record last updated Jan 23, 2026
Key facts
- NPI
- 1629927561
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4052401 (KY)
- Practice address
- 155 Left Fork of Grassy CRK
Staffordsville, KY 41256-9109 - Phone
- (606) 225-3530
- NPI assigned
- Jan 23, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
155 Left Fork of Grassy CRK
Staffordsville, KY 41256-9109
4350 Brownsboro Rd
Suite 210
Louisville, KY 40207-1600
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4052401 | KY | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4052401 | KY | Yes |
Addresses
Primary practice location
155 Left Fork of Grassy CRK
Staffordsville, KY 41256-9109
Mailing address
155 Left Fork of Grassy CRK
Staffordsville, KY 41256-9109
Other providers in Staffordsville, KY
- Traci Campbell
- Conley Brothers LLC
- Conley Brothers LLC
- Coty Conley
- Dr Mark J Hovee PSYD LLC
- Terri Lynn Hall
- Johnson County Health Dept
- Carlee Jlynn Salisbury
- Anna Whitaker Shepherd
- Leah Stephens
All providers in Staffordsville, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.