NPIMap

Individual provider Active NPI

Alisha L Grimmage, APRN

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1679137863
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9344489 Issued in FL
Practice address
1750 16TH St S Unit 35207
Saint Petersburg, FL 33705-8009
Phone
(813) 644-9372
Fax
(727) 499-6912
NPI assigned
Apr 24, 2019
Last updated
Nov 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9344489 FL
Family Nurse Practitioner 363LF0000X APRN9344489 FL Primary

Addresses

Primary practice location

1750 16TH St S Unit 35207
Saint Petersburg, FL 33705-8009

Mailing address

1750 16TH St S Unit 35207
St Petersburg, FL 33705-8009
Phone (813) 644-9372

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190626002932 FL Practitioner - Nurse Practitioner 0648504530 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

St Petersburg, FL 33705
Phone (813) 644-9372

1750 16TH St S
Unit 35207
St Petersburg, FL 33705-8009

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9344489FLMDFamily Nurse Practitioner
APRN9344489FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas Inc. CurrentSince Mar 19, 2020 Accepting new patients
Clinicare Clinical Services, Inc. CurrentSince Jun 15, 2021 Accepting new patients
Healthcare Made for You LLC CurrentSince Jun 1, 2021 Accepting new patients
Professional Health Care of Pinellas LLC CurrentSince Mar 19, 2020 Accepting new patients

Locations

2112 Sunnydale Blvd
Ste B
Clearwater, FL 33765
Phone (727) 796-2904

1750 16th St S
Unit 35207
St Petersburg, FL 33705
Phone (813) 644-9372

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1679137863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 16TH ST S UNIT 35207",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337058009",
            "telephone_number": "813-644-9372",
            "fax_number": "727-499-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 16TH ST S UNIT 35207",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337058009",
            "telephone_number": "813-644-9372",
            "fax_number": "727-499-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMMAGE",
        "first_name": "ALISHA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2021-11-17",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9344489",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9344489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.