Individual provider Active NPI

Jamie Alan Grider, D.D.S.

  • Durable Medical Equipment & Medical Supplies
  • Murfreesboro, TN
National Provider Identifier
1922078393
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
8431 Issued in TN
Practice address
2863 Old Fort Pkwy Ste C
Murfreesboro, TN 37128-4418
Phone
(615) 867-1735
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012683 GA
General Practice Dentistry 1223G0001X DS0000008431 TN
Durable Medical Equipment & Medical Supplies 332B00000X 8431 TN Primary

Addresses

Primary practice location

2863 Old Fort Pkwy Ste C
Murfreesboro, TN 37128-4418

Mailing address

2863 Old Fort Pkwy Ste C
Murfreesboro, TN 37128-4418
Phone (615) 867-1735

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN012683GAMDGeneral Practice Dentistry
DS0000008431TNMDGeneral Practice Dentistry
8431TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Snore Prevention Solutions LLC Durable Medical Equipment & Medical Supplies CurrentSince Aug 2, 2020 Accepting new patients
Legacy Family Dental Past Accepting new patients

Locations

2863 Old Fort Pkwy
Ste C
Murfreesboro, TN 37128
Phone (615) 867-1735

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1922078393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2863 OLD FORT PKWY STE C",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371284418",
            "telephone_number": "615-867-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 OLD FORT PKWY STE C",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371284418",
            "telephone_number": "615-867-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIDER",
        "first_name": "JAMIE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012683",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS0000008431",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "8431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.