JACOB GRIME (NPI# 1134751456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134751456 |
| Entity Type | Individual |
| Full Name | JACOB GRIME |
| Credential | FNP |
| Practice Address |
735 S Shoop Ave Wauseon OH 43567-1735 |
| Practice Telephone | 4193353242 |
| Practice Fax Number | 4193353222 |
| Mailing Telephone | 4193353242 |
| Mailing Fax Number | 4193353222 |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-02-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN.CNP.025835 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
735 S SHOOP AVE |
| City | WAUSEON |
| State | OH |
| Zip Code | 43567-1735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588657670 | Philip F Ashton | Internal Medicine | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2005-08-24 |
| 1689057606 | Carrianne M Baden | Nurse Practitioner | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2015-07-08 |
| 1912312422 | Billie Denton-miller | Nurse Practitioner | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2014-06-23 |
| 1477967628 | Tiffany N Siegel | Nurse Practitioner | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2014-06-16 |
| 1932530649 | Brenda Marie Hoops | Nurse Practitioner | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2013-12-05 |
| 1376979286 | Marissa Mae Baus | Nurse Practitioner | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2013-09-24 |
| 1992956965 | Fchc Medical Care, L.L.C. | Family Medicine | 735 S Shoop Ave, Suite 4, Wauseon, OH 43567-1735 | 2008-10-08 |
| 1255598439 | Fchc Medical Care LLC | Orthopaedic Surgery | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2008-05-16 |
| 1093994360 | Fchc Medical Care, LLC | Obstetrics & Gynecology | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2007-11-02 |
| 1710038062 | Empicare, Inc. | Durable Medical Equipment & Medical Supplies | 735 S Shoop Ave, Suite A, Wauseon, OH 43567-1735 | 2007-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700302619 | Lisa Michelle Aschliman | Physical Therapy Assistant | 138 E Elm St. Fulton Co Health Center Rehab, Wauseon, OH 43567 | 2017-08-22 |
| 1245755164 | Kimberly Sue Fall | Home Health | 847 Wood Street, Wauseon, OH 43567 | 2017-08-11 |
| 1639580160 | Julie Ann Leatherman | Social Worker | 241 Philomena Dr, Wauseon, OH 43567 | 2014-05-19 |
| 1194054916 | Jessica Sue Demaline | Social Worker | 7320 State Hughway 108, Suite A, Wauseon, OH 43567 | 2009-12-08 |
| 1659503043 | Crissi L Stuckey | Physical Therapist | 303 West Leggett Street, Wauseon, OH 43567 | 2009-08-18 |
| 1912194614 | Family Services of Nw Ohio Suite 414 Toledo, Ohio 43604 | Community/Behavioral Health | 7320 State Hwy 108, Wauseon, OH 43567 | 2007-09-27 |
| 1750508768 | Renal Treatment Centers Illinois Inc | Clinic/Center | 721 S Shoop Ave, Wauseon, OH 43567 | 2007-04-19 |
| 1922155563 | Sema Justus Fofung | Specialist | 735 South Shoop Avenue, Suite 3, Wauseon, OH 43567 | 2007-01-05 |
| 1679679948 | Jessye Hartman | Physical Therapist | 138 E Elm St, Wauseon, OH 43567 | 2006-09-15 |
| 1336155837 | James A Williams | Chiropractor | 1485 N Shoop Ave, Wauseon, OH 43567 | 2006-08-01 |
| Find all providers in zip 43567 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376010728 | Hayley L. Baldwin | Nurse Practitioner | 1190 N Shoop Ave, Wauseon, OH 43567-2214 | 2018-10-24 |
| 1609324748 | Denise Nofziger | Nurse Practitioner | 725 S Shoop Ave, Wauseon, OH 43567-1702 | 2016-09-19 |
| 1225403041 | Michelle G Haas | Nurse Practitioner | 1190 N Shoop Ave, Wauseon, OH 43567-2224 | 2015-12-04 |
| 1073984993 | Michelle Haas | Nurse Practitioner | 1190 N Shoop Ave, Wauseon, OH 43567-2224 | 2015-10-19 |
| 1689057606 | Carrianne M Baden | Nurse Practitioner | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2015-07-08 |
| 1932530649 | Brenda Marie Hoops | Nurse Practitioner | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2013-12-05 |
| 1376979286 | Marissa Mae Baus | Nurse Practitioner | 735 S Shoop Ave, Wauseon, OH 43567-1735 | 2013-09-24 |
| 1821346230 | Brandy M Secory | Nurse Practitioner | 725 S Shoop Ave, Wauseon, OH 43567-1702 | 2012-08-16 |
| 1275889404 | Brenda S Schulty | Nurse Practitioner | 725 S Shoop Ave, Wauseon, OH 43567-1702 | 2012-07-25 |
| 1093860512 | Rosemary Ann Fisher | Nurse Practitioner | 725 S Shoop Ave, Wauseon, OH 43567-1702 | 2007-01-24 |
| Find all providers in WAUSEON | ||||
Please comment or provide details below to improve the information on JACOB GRIME.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.