Individual provider Active NPI

Stephen E Grinde, MD

  • Ophthalmology Physician
  • Nashville, TN
National Provider Identifier
1740279660
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD0000014954 Issued in TN
Practice address
2010 Church St
Suite 603
Nashville, TN 37203-2012
Phone
(615) 284-5755
Fax
(615) 284-5759
NPI assigned
Oct 14, 2005
Last updated
Apr 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD0000014954 TN Primary
Ophthalmology Physician 207W00000X 27981 KY

Addresses

Primary practice location

2010 Church St
Suite 603
Nashville, TN 37203-2012

Mailing address

3443 Dickerson Pike
Suite 200
Nashville, TN 37207-2539
Phone (615) 860-5773

Other identifiers 2

IdentifierTypeStateIssuer
3000892MedicaidTN
64772841MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000724 TN Practitioner - Ophthalmology 2961547401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000014954TNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Ophthalmology Services Foundation Ophthalmology Past Accepting new patients

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1740279660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE",
            "address_2": "SUITE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072539",
            "telephone_number": "615-860-5773",
            "fax_number": "615-860-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 CHURCH ST",
            "address_2": "SUITE 603",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032012",
            "telephone_number": "615-284-5755",
            "fax_number": "615-284-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINDE",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD0000014954",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "27981",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000892",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64772841",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.