Individual provider Active NPI

Bennett Douglas Grimm, MD

  • Orthopaedic Surgery Physician
  • Marietta, GA
National Provider Identifier
1891877742
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
068525 Issued in GA
Practice address
61 Whitcher St NE
Suite 1100
Marietta, GA 30060-1176
Phone
(770) 422-3290
Fax
(770) 422-0287
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2012-00860 NC
Orthopaedic Surgery Physician 207X00000X 068525 GA Primary

Addresses

Primary practice location

61 Whitcher St NE
Suite 1100
Marietta, GA 30060-1176

Mailing address

61 Whitcher St NE
Suite 1100
Marietta, GA 30060-1176
Phone (770) 422-3290

Other identifiers 3

IdentifierTypeStateIssuer
003136592AMedicaidGA
003136592CMedicaidGA
003136592BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130821000563 GA Practitioner - Orthopedic Surgery 2062681745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Georgia School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

61 Whitcher St NE
Suite 1100
Marietta, GA 30060-1177
Phone (770) 422-3290

655 Molly LN
Woodstock, GA 30189-6519
Phone (770) 517-1080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion68
Laminectomy or laminotomy (partial removal of spine bones)23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
068525GAMDOrthopaedic Surgery Physician
2012-00860NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Aug 31, 2013 Accepting new patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Aug 31, 2013 Accepting new patients

Locations

1495 Hickory Flat Hwy
Ste 200
Canton, GA 30115
Phone (678) 505-4455

61 Whitcher St NE
Ste 1100
Marietta, GA 30060
Phone (615) 686-2262

790 Church St NE
Ste 300
Marietta, GA 30060
Phone (770) 422-3290

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

Interoperability endpoints

  • Direct secure messaging: bennet.grimm.1@15749.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1891877742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE",
            "address_2": "SUITE 1100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601176",
            "telephone_number": "770-422-3290",
            "fax_number": "770-422-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE",
            "address_2": "SUITE 1100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601176",
            "telephone_number": "770-422-3290",
            "fax_number": "770-422-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "BENNETT",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2012-00860",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "068525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136592A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136592C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136592B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.