Active NPI
Amy Lyn Grimes, O.D.
- Optometrist
- Tucson, AZ
National Provider Identifier
1902910573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1005
- Practice address
- 3601 S. 6TH Ave
(2-112A)
Tucson, AZ 85723 - Phone
- (520) 792-1450
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Low Vision Rehabilitation Optometrist | 152WL0500X | OPT-001005 | AZ | |
| Optometrist | 152W00000X | 1005 | AZ | Primary |
Addresses
Primary practice location
3601 S. 6TH Ave
(2-112A)
Tucson, AZ 85723
Mailing address
784 W. Annandale Way
Oro Valley, AZ 85737-6955
Phone (520) 229-0160
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 886509 | Medicaid | AZ |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT-001005 | AZ | MD | Low Vision Rehabilitation Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740700800000",
"number": "1902910573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "784 W. ANNANDALE WAY",
"city": "ORO VALLEY",
"state": "AZ",
"postal_code": "857376955",
"telephone_number": "520-229-0160",
"fax_number": "520-838-3656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 S. 6TH AVE",
"address_2": "(2-112A)",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85723",
"telephone_number": "520-792-1450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "AMY",
"middle_name": "LYN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2025-02-28",
"certification_date": "2025-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "AZ",
"license": "OPT-001005",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "1005",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "886509",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.