Individual provider Active NPI

Paula Marie Grimwood

  • Pharmacist
  • Evansville, IN
National Provider Identifier
1720673643
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26014037A Issued in IN
Practice address
401 N Burkhardt Rd
Evansville, IN 47715-2733
Phone
(812) 474-1715
NPI assigned
Mar 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26014037A IN Primary

Addresses

Primary practice location

401 N Burkhardt Rd
Evansville, IN 47715-2733

Mailing address

4408 Clover Dr
Evansville, IN 47711-2904
Phone (812) 457-5059

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
26014037AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1720673643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4408 CLOVER DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477112904",
            "telephone_number": "812-457-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BURKHARDT RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152733",
            "telephone_number": "812-474-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMWOOD",
        "first_name": "PAULA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26014037A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.