Individual provider Active NPI

Keith Case Grim, MD

  • Emergency Medicine Physician
  • Somers Point, NJ
National Provider Identifier
1992766760
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA07746000 Issued in NJ
Practice address
1 E New York Avenue
Somers Point, NJ 08244
Phone
(609) 653-3519
Fax
(609) 653-3247
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA07746000 NJ Primary

Addresses

Primary practice location

1 E New York Avenue
Somers Point, NJ 08244

Mailing address

1 E New York Ave
Somers Point, NJ 08244-2340
Phone (609) 653-3519

Other identifiers 1

IdentifierTypeStateIssuer
0061280MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050223000063 NJ Practitioner - Emergency Medicine 5496708133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
33.62 of 100Reported as individual
Quality
30
Improvement activities
0
Cost
52.73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayfront Emergency Physicians PA Emergency Medicine CurrentSince Jul 1, 2004 Accepting new patients
Shore Family Medicine Ass Past Accepting new patients
Main Line Emergency Med Associates LLC Emergency Medicine Past Accepting new patients

Locations

56 W Main St
Ste 203
Christiana, DE 19702

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1992766760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E NEW YORK AVE",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442340",
            "telephone_number": "609-653-3519",
            "fax_number": "609-653-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E NEW YORK AVENUE",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "08244",
            "telephone_number": "609-653-3519",
            "fax_number": "609-653-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIM",
        "first_name": "KEITH",
        "middle_name": "CASE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA07746000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061280",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers Point, NJ

Sources for this page

Verify at the official NPI Registry.