Richard Scott Grimshaw, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC002051 Issued in FL

Practice address

1840 Dunn Ave Ste 4
Jacksonville, FL 32218-4785

Phone

(904) 751-4483

Fax

(904) 751-0890

NPI assigned

Apr 20, 2006

Last updated

Jul 19, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Vision IncGroup PAC ID 8022029222, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Gateway Vision Inc

  • Optometrist
  • Atlantic Beach, FL
  • NPI 1205885886
  Medicare reassignment Care Compare group NPD Authorized official
• Gateway Vision Inc

  • Optometrist
  • Jacksonville, FL
  • NPI 1740548767
  NPD Authorized official
• Gateway Vision, Inc

  • Optometrist
  • Jacksonville, FL
  • NPI 1447420443
  NPD (past) Authorized official

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1912963877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 ATLANTIC BLVD",
            "address_2": "STE 1",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322334050",
            "telephone_number": "904-247-0211",
            "fax_number": "904-246-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 DUNN AVE STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184785",
            "telephone_number": "904-751-4483",
            "fax_number": "904-751-0890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "447 Atlantic Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Atlantic Beach",
            "state": "FL",
            "postal_code": "322334050",
            "country_code": "US",
            "telephone_number": "904-247-0211",
            "fax_number": "904-246-6115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMSHAW",
        "first_name": "RICHARD",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC002051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078621700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Grimball, PHARMD
• Hallie Elizabeth Grimes
• Joshua Kyle Grimes, PA-C
• Linda Lee Grimes
• Yolanda Anternett Grimes, LPN
• Richard R. Grimsley, MD
• Lea Grinberg-Korczyn, M.D, PHD
• Shane D Grindle, APRN
• Breanna Griner
• Michael Grinney, MD

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.