Individual provider Active NPI

Michael D Grimes, MD

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1972569028
Registry record updated May 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-25925 Issued in KS
Practice address
1900 N Amidon Ave
Ste 100
Wichita, KS 67203-2125
Phone
(316) 832-9024
Fax
(316) 832-9478
NPI assigned
Apr 25, 2006
Last updated
May 8, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-25925 KS Primary

Addresses

Primary practice location

1900 N Amidon Ave
Ste 100
Wichita, KS 67203-2125

Mailing address

PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135

Other identifiers 2

IdentifierTypeStateIssuer
100289990DMedicaidKS
003719199OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050713001190 KS Practitioner - Family Practice 5698701373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1900 N Amidon Ave
100 Via Christi Clinic PA
Wichita, KS 67203-2125
Phone (316) 832-9024

1947 N Founders Cir
Via Christi Clinic PA
Wichita, KS 67206-3548
Phone (316) 613-4640

3311 E Murdock St
Wichita, KS 67208-3054
Phone (316) 689-9349

8444 W 21St St N
Via Christi Clinic PA
Wichita, KS 67205-1752
Phone (316) 721-9500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Oct 1, 2012 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Oct 1, 2012 Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients

Locations

1900 N Amidon Ave
Ste 100
Wichita, KS 67203
Phone (316) 687-1555

3009 N Cypress St
Wichita, KS 67226
Phone (316) 261-3111

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1972569028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135",
            "fax_number": "316-689-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N AMIDON AVE",
            "address_2": "STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672032125",
            "telephone_number": "316-832-9024",
            "fax_number": "316-832-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-25925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100289990D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719199",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.