Shannon A Grime, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

COA.18361-NP Issued in OH

Practice address

3400 Olentangy River Rd
Columbus, OH 43202-1523

Phone

(614) 754-5500

Fax

(614) 457-9519

NPI assigned

Sep 22, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Shannon A Burkholder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1902275787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-457-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-457-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIME",
        "first_name": "SHANNON",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "312107",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.18361-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13586175",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BURKHOLDER",
            "middle_name": "A",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roger L Grigsby
• Andrea Grile, RD, LD
• Alexis S. Grill, APRN-CNP
• Devin L Grime
• Justin L. Grime, APRN.CRNA
• Amanda Grimes
• Eli Alshbasi Grimes
• Laparis S Grimes
• Laura Marie Grimm, PA
• Elisa Starr Grimmette

• Adult Health Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.