Active NPI
Stephen Nelson Grimes, M.D.
- Ophthalmology Physician
- Warwick, RI
National Provider Identifier
1730175415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD04824
- Practice address
- 566 Toll Gate Rd
Warwick, RI 02886-2716 - Phone
- (401) 738-4800
- Fax
- (401) 738-0174
- NPI assigned
- Sep 27, 2005
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD04824 | RI | Primary |
Addresses
Primary practice location
566 Toll Gate Rd
Warwick, RI 02886-2716
Mailing address
566 Tollgate Road
Warwick, RI 02886-2716
Phone (401) 738-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SG00626 | Medicaid | RI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301875200000",
"number": "1730175415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "566 TOLLGATE ROAD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862716",
"telephone_number": "401-738-4800",
"fax_number": "401-738-0174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "566 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862716",
"telephone_number": "401-738-4800",
"fax_number": "401-738-0174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "STEPHEN",
"middle_name": "NELSON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2011-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "RI",
"license": "MD04824",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SG00626",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.