Active NPI
Melinda Grimes, MSPT
- Pediatric Physical Therapist
- Conway, AR
National Provider Identifier
1750419529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT1471
- Practice address
- 1700 South Blvd
Conway, AR 72034-6455 - Phone
- (501) 329-8102
- NPI assigned
- Mar 1, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT1471 | AR | Primary |
Addresses
Primary practice location
1700 South Blvd
Conway, AR 72034-6455
Mailing address
48 Middle Rd
Conway, AR 72032-9017
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 |
|---|---|---|---|
| PT1471 | AR | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1750419529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 MIDDLE RD",
"city": "CONWAY",
"state": "AR",
"postal_code": "720329017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 SOUTH BLVD",
"city": "CONWAY",
"state": "AR",
"postal_code": "720346455",
"telephone_number": "501-329-8102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "MELINDA",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AR",
"license": "PT1471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.