Samuel Oliver Grimm III, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0101043338 Issued in VA

Practice address

10521 Rosehaven St
Suite LL 100
Fairfax, VA 22030-2837

Phone

(703) 281-5000

Fax

(703) 255-0765

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Virginia Gynecologists, LTD

  • Obstetrics & Gynecology Physician
  • Vienna, VA
  • NPI 1962438119
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1841223674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 MAPLE LAWN BLVD STE 235",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592694",
            "telephone_number": "301-340-8339",
            "fax_number": "301-340-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 ROSEHAVEN ST",
            "address_2": "SUITE LL 100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302837",
            "telephone_number": "703-281-5000",
            "fax_number": "703-255-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "SAMUEL",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101043338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "V006215653",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samuel.grimm.p1@direct.cwcare.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10521 Rosehaven St",
            "address_2": "Suite LL 100",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220302837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey Fitzgerald Grilliot, PT
• Lynn Grillo, NP
• Kimberley Grimes, LCSW
• Jennifer Grimley
• Jenna Emily Grimm, LNP
• John Robert Grimsley
• Diane Marie Grinage, M.A., M.S. - CCC/SLP
• Naomi Grinney, LCSW
• Meredith Kathleen Grisamore, M.ED. CCC-SLP
• Kristine Platt Griswold, MSW

• Obstetrics & Gynecology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.