Active NPI
Jeremiah Grimm
- Pharmacist
- Fredericksburg, VA
National Provider Identifier
1700497344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202217284
- Practice address
- 50 White Oak Rd
Fredericksburg, VA 22405-2551 - Phone
- (540) 368-5870
- Fax
- (540) 372-2077
- NPI assigned
- Aug 16, 2020
- Last updated
- Aug 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202217284 | VA | Primary |
Addresses
Primary practice location
50 White Oak Rd
Fredericksburg, VA 22405-2551
Mailing address
50 White Oak Rd
Fredericksburg, VA 22405-2551
Phone (540) 368-5870
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0202217284 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
50 White Oak Rd
Fredericksburg, VA 22405
Phone (540) 368-5870
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597536000000",
"number": "1700497344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 WHITE OAK RD",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224052551",
"telephone_number": "540-368-5870",
"fax_number": "540-372-2077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 WHITE OAK RD",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224052551",
"telephone_number": "540-368-5870",
"fax_number": "540-372-2077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "JEREMIAH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-16",
"last_updated": "2020-08-16",
"certification_date": "2020-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202217284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.