Mark Steven Grimsley, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

41572 Issued in GA

Practice address

1611 Satellite Blvd Ste 3
Duluth, GA 30097

Phone

(770) 614-6266

NPI assigned

Nov 12, 2009

Last updated

Jan 18, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Vitality Ageless Center LLC

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1326843277
  NPD

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1861729816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 SATELLITE BLVD STE 3",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974913",
            "telephone_number": "770-614-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 SATELLITE BLVD STE 3",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-614-6266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3091 Battlefield Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Oglethorpe",
            "state": "GA",
            "postal_code": "307424003",
            "country_code": "US",
            "telephone_number": "423-414-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMSLEY",
        "first_name": "MARK",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "41572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Blake Greer, MD
• Jonathan Raines Greifer, M.D.
• Monique A Grey-McBride, M.D.
• Kasey Ora Griffin
• Marcus C Griffith, M.D.
• Joanna Grisik, R.PH
• Daniel Craig Grizzle, M.D.
• Ana Silvia Grosso, MD
• Grow Deep Counseling, LLC
• Joseph G Guagliardo, D.C.

• Family Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.