Individual provider Active NPI

Thomas W Grimm, M.D.

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1659363687
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35053367 Issued in OH
Practice address
11029 Montgomery Rd
Cincinnati, OH 45249-2306
Phone
(513) 891-2211
Fax
(513) 891-2218
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35053367 OH Primary

Addresses

Primary practice location

11029 Montgomery Rd
Cincinnati, OH 45249-2306

Mailing address

PO Box 637676
Cincinnati, OH 45263-0001
Phone (513) 891-2211

Other identifiers 1

IdentifierTypeStateIssuer
0638699MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607001090 OH Practitioner - Family Practice 9739122094 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35053367OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G LLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
Trihealth G, LLC CurrentSince Jan 1, 2016 Accepting new patients

Locations

11029 Montgomery Rd
Cincinnati, OH 45249
Phone (513) 891-2211

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

9030 Montgomery Rd
Cincinnati, OH 45242
Phone (513) 505-6800

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

425 Farrell Ct
Cincinnati, OH 45233
Phone (513) 451-6871

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

Interoperability endpoints

  • Direct secure messaging: tgrimm1667@direct.trihealth.com

Organizations & group practices 2

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1659363687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637676",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "513-891-2211",
            "fax_number": "513-891-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11029 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492306",
            "telephone_number": "513-891-2211",
            "fax_number": "513-891-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35053367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0638699",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.