MR. RANDY CLARENCE ANTHONY GRIMSHAW (NPI# 1710467246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710467246 |
| Entity Type | Individual |
| Full Name | MR. RANDY CLARENCE ANTHONY GRIMSHAW |
| Credential | PA-C |
| Practice Address |
159 Barnegat Rd Ste 101 Poughkeepsie NY 12601-5402 |
| Mailing Address |
98 Miller Rd Apt 101 Rhinebeck NY 12572-3559 |
| Practice Telephone | 8454541942 |
| Mailing Telephone | 5185344585 |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 022495 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
159 BARNEGAT RD STE 101 |
| City | POUGHKEEPSIE |
| State | NY |
| Zip Code | 12601-5402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922669977 | Rebecca Ivonne White | Nurse Practitioner | 159 Barnegat Rd Ste 101, Poughkeepsie, NY 12601-5402 | 2019-06-20 |
| 1861972689 | Susan Christine Stanforth | Nurse Practitioner | 159 Barnegat Rd Ste 101, Poughkeepsie, NY 12601-5402 | 2018-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194348425 | Hudson Valley Radiologists, PC | Radiology | 57 Kingwood Park, Poughkeepsie, NY 12601 | 2020-05-21 |
| 1063049088 | Jaquellah Taylor | Student in an Organized Health Care Education/Training Program | Vassar Brother Medical Center 45 Reade Place, Poughkeepsie, NY 12601 | 2020-03-27 |
| 1053957050 | Jasmine Syin-lan Miller | Student in an Organized Health Care Education/Training Program | 3399 North Road, Marist College Msc 12617, Poughkeepsie, NY 12601 | 2019-11-25 |
| 1144864224 | Kim Beverly | Technician | 16 Tamidan Road, Poughkeepsle, NY 12601 | 2019-11-01 |
| 1851852768 | Marwa H Abdalla | Student in an Organized Health Care Education/Training Program | Vassar Brother Medical Center, 45 Reade Place, Poughkeepsie, NY 12601 | 2019-03-26 |
| 1619459047 | Victoria Bozydaj | Occupational Therapy Assistant | 50 Rinaldi Boulevard Apt 7r, Poughkeepsie, NY 12601 | 2018-09-01 |
| 1821589953 | Avo Gregory Serafino | Physician Assistant | 228 Donnelly, Poughkeepsie, NY 12601 | 2018-05-24 |
| 1649771486 | Raewyn Kalisha Clayton | Registered Nurse | 31 Forbus Street Apt C2, Poughkeepsie, NY 12601 | 2018-02-27 |
| 1780108761 | Ronica Dorothy White | Licensed Practical Nurse | 7c Muldowney Circle, Poughkeepsie, NY 12601 | 2017-08-01 |
| 1336662048 | Ashley Elizabeth Travers | Licensed Practical Nurse | 100 Innis Ave, Poughkeepsie, NY 12601 | 2017-07-25 |
| Find all providers in zip 12601 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821589953 | Avo Gregory Serafino | Physician Assistant | 228 Donnelly, Poughkeepsie, NY 12601 | 2018-05-24 |
| 1184903916 | Lauren Van Buren | Physician Assistant | 207 Washington St Ste 103, Poughkeepsie, NY 12601-8112 | 2011-08-10 |
| 1295971356 | Maria Badami | Physician Assistant | 19 Baker Ave # 100, Poughkeepsie, NY 12601-1359 | 2008-12-19 |
| 1164455564 | Nicholas Adam Fanok | Physician Assistant | 1910 South Rd., Poughkeepsie, NY 12601-6027 | 2006-07-09 |
| 1417920745 | Kevin Joseph Torrens | Physician Assistant | 55 Eastdale Ave N, Poughkeepsie, NY 12603 | 2006-02-08 |
| 1184617185 | Bridget R Beebe | Physician Assistant | 1910 South Rd, Poughkeepsie, NY 12601-6027 | 2005-08-24 |
| 1942812458 | Anthony Michael Cicalese | Physician Assistant | 1910 South Rd, Poughkeepsie, NY 12601-6053 | 2020-08-18 |
| 1871103382 | Jessica Deboer Ely | Physician Assistant | 1910 South Rd, Poughkeepsie, NY 12601-6053 | 2020-08-10 |
| 1952912404 | Alexandra Livia Balan | Physician Assistant | 159 Barnegat Rd, Poughkeepsie, NY 12601 | 2020-08-10 |
| 1770106874 | Marissa Lyn Campilii | Physician Assistant | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2020-05-22 |
| Find all providers in POUGHKEEPSIE | ||||
| City | POUGHKEEPSIE |
| Zip Code | 12601 |
Please comment or provide details below to improve the information on MR. RANDY CLARENCE ANTHONY GRIMSHAW.
| 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.