William R Grimes, ARNP

Individual provider Active NPI Family Nurse Practitioner · Owingsville, KY

NPI 1962590364 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1962590364
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
630P (KY)
Practice address
632 Slate Avenue
Owingsville, KY 40360
Phone
(606) 674-6386
Fax
(606) 674-3096
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
630KYMDMental Health Counselor
630PKYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Claire Regional Medical Center Past Accepting new patients
St. Claire Medical Center, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: william.grimes.1@17066.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 630P KY Yes

Addresses

Primary practice location

632 Slate Avenue
Owingsville, KY 40360

Mailing address

PO Box 1120
Owingsville, KY 40360-1120
Phone (606) 674-6386

Other providers in Owingsville, KY

All providers in Owingsville, KY · Family Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.