Active NPI
Ashley Lee Grimm, RDN, LD/N
- Registered Dietitian
- St Petersburg, FL
National Provider Identifier
1821710815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86130728
- Practice address
- 853 3Rd Ave N
St Petersburg, FL 33701-2703 - Phone
- (501) 365-6552
- NPI assigned
- Sep 15, 2022
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86130728 | FL | Primary |
Addresses
Primary practice location
853 3Rd Ave N
St Petersburg, FL 33701-2703
Mailing address
853 3Rd Ave N
St Petersburg, FL 33701-2703
Phone (501) 365-6552
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 |
|---|---|---|---|
| 86130728 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663200000000",
"number": "1821710815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "853 3RD AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337012703",
"telephone_number": "501-365-6552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "853 3RD AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337012703",
"telephone_number": "501-365-6552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "ASHLEY",
"middle_name": "LEE",
"credential": "RDN, LD/N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-15",
"last_updated": "2022-09-15",
"certification_date": "2022-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "86130728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.