Individual provider Active NPI

Maren Grimm, RPA

  • Radiology Practitioner Assistant
  • Santa Ana, CA
National Provider Identifier
1679266753
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
License
RHT00113706 Issued in CA
Practice address
1100 N Tustin Ave Ste a
Santa Ana, CA 92705-3509
Phone
(714) 643-5963
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner Assistant 243U00000X RHT00113706 CA Primary

Addresses

Primary practice location

1100 N Tustin Ave Ste a
Santa Ana, CA 92705-3509

Mailing address

1100 N Tustin Ave Ste a
Santa Ana, CA 92705-3509

Other practice location 1

230 S Main St Ste 101
Orange, CA 92868-3851
Phone (714) 643-2937 ext. 5044

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

LicenseStateTypeSpecialty
RHT00113706CAMDRadiology Practitioner Assistant

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1679266753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N TUSTIN AVE STE A",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N TUSTIN AVE STE A",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053509",
            "telephone_number": "714-643-5963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 S Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683851",
            "country_code": "US",
            "telephone_number": "714-643-2937 x5044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "MAREN",
        "credential": "RPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "",
            "desc": "Radiology Practitioner Assistant",
            "state": "CA",
            "license": "RHT00113706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.