Individual provider Active NPI

Jonathan C Grimes, MD

  • Emergency Medicine Physician
  • Woodbury, MN
National Provider Identifier
1891721759
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
36958 Issued in MN
Practice address
1925 Woodwinds Dr
Woodbury, MN 55125-2270
Phone
(651) 232-0348
NPI assigned
Jun 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 36958 MN Primary

Addresses

Primary practice location

1925 Woodwinds Dr
Woodbury, MN 55125-2270

Mailing address

5680 Hadley Ave N
Apt. 201
Oakdale, MN 55128-1004
Phone (651) 255-6571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100318000977 MN Practitioner - Emergency Medicine 4183759814 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36958MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Woodwinds Hospital CurrentSince Aug 1, 2000 Accepting new patients
Healtheast St. John's Hospital CurrentSince Aug 1, 2000 Accepting new patients
Emergency Care Consultants, PA Emergency Medicine CurrentSince Sep 1, 2017 Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients

Locations

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

Interoperability endpoints

  • Direct secure messaging: jgrimes628741@fairview.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891721759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 HADLEY AVE N",
            "address_2": "APT. 201",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551281004",
            "telephone_number": "651-255-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252270",
            "telephone_number": "651-232-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "JONATHAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "36958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.