Active NPI
Daniel Joseph Grimes, CPED
- Prosthetic/Orthotic Supplier
- Tulsa, OK
National Provider Identifier
1861620882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- 109
- Practice address
- 6112 E 61St St
Tulsa, OK 74136-2117 - Phone
- (918) 408-0589
- Fax
- (918) 272-0071
- NPI assigned
- Jun 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | 109 | OK | Primary |
Addresses
Primary practice location
6112 E 61St St
Tulsa, OK 74136-2117
Mailing address
6112 E 61St St
Tulsa, OK 74136-2117
Phone (918) 408-0589
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 |
|---|---|---|---|
| 109 | OK | MD | Prosthetic/Orthotic Supplier |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246233600000",
"number": "1861620882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6112 E 61ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741362117",
"telephone_number": "918-408-0589",
"fax_number": "918-272-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6112 E 61ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741362117",
"telephone_number": "918-408-0589",
"fax_number": "918-272-0071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "DANIEL",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "CPED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-29",
"last_updated": "2009-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "OK",
"license": "109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.