MANDY GRIMM (NPI# 1831333996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831333996 |
| Entity Type | Individual |
| Full Name | MANDY GRIMM |
| Credential | IDMT |
| Practice Address |
559 Vincent St Colorado Springs CO 80914-1541 |
| Practice Telephone | 7194743862 |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
559 VINCENT ST |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80914-1541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639792195 | Sarah Whitney Jackson | Pharmacist | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2020-05-19 |
| 1811378607 | Justin Henry Noble | Family Medicine | 559 Vincent St, Colorado Springs, CO 80914 | 2015-06-17 |
| 1700276730 | Theresa Gilbert | Pharmacist | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2015-01-29 |
| 1558694935 | Patti Jo Irene Demotts | Registered Nurse | 559 Vincent St, 21st Medical Group, Colorado Springs, CO 80914-1541 | 2009-09-16 |
| 1740417641 | David Andrew Holman | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-06-18 |
| 1386879633 | Edward L Nelson Jr. | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-05-15 |
| 1386887792 | Jovonne D Parnell | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-04-15 |
| 1366652653 | Dawn Angelen Scovel | Social Worker | 559 Vincent St, Attn: 21mdos/sgoh, Colorado Springs, CO 80914-1541 | 2007-05-23 |
| 1487701116 | Lloyd Christopher Scharfenstine | Physician Assistant | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2007-01-04 |
| 1730258732 | Hans Joseph Meissnest | Physical Therapist | 559 Vincent St, Attn: 21 Mdos/sgoy -pt, Colorado Springs, CO 80914-1540 | 2006-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356897250 | Kym Littlefield Whitaker | Nurse Practitioner | 110 Ent Avenue, Peterson Afb, CA 80914 | 2016-08-30 |
| 1114322583 | Jessica Charmaine Johnson | Social Worker | 559 Vincent St, Bldg 959, Attn: 21 Omrs/sgow, Peterson Afb, CO 80914 | 2014-10-28 |
| 1306916267 | John Frank Drozd | Psychologist | 21st Medical Group, 559 Vincent Street, Peterson Afb, CO 80914 | 2006-11-08 |
| 1801858865 | Moshe Mark Douglas Wexler | Clinical Neuropsychologist | 110 W. Ent Ave. Bldg 725, 21 Mdos/sgoh, Pafb, CO 80914 | 2006-04-05 |
| 1215902002 | William J Dickson | Dentist | Peterson Afb, Bld 950, Colorado Springs, CO 80914 | 2006-02-23 |
| 1740889773 | Brandon Dean Estes | Dental Hygienist | 1055 Stewart Ave, Bldg 2018, Apo, AA 80914 | 2020-10-21 |
| 1225458789 | Brianna Mcmurray | Family Medicine | 559 Vincent St Bldg 959, Colorado Springs, CO 80914 | 2014-04-23 |
| 1720406796 | Beth D Achterhoff | Physical Therapist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914 | 2014-04-07 |
| 1275712895 | Monica Ibarra | Counselor | 559 Vincent St., Attn: 21 Mdos/sgow - Family Advocacy, Peterson Afb, CO 80914 | 2007-10-31 |
| 1912258591 | Ruth Angela Monsanto-williams | Nurse Practitioner | 110 West Ent Ave, Peterson Afb, 21st Medical Group, Colorado Springs, CO 80914-1540 | 2012-09-24 |
| Find all providers in zip 80914 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255754214 | Lynor Dicang Hardy | Military Health Care Provider | Cheyenne Mountain Air Station, Colorado Springs, CO 80922 | 2014-01-28 |
| 1912243239 | Lerinda Kay Carle | Military Health Care Provider | 6676 Myrtle Creek Dr, Colorado Springs, CO 80927-4034 | 2012-12-13 |
| 1851675011 | Susanne Clariece Fry | Military Health Care Provider | 2540 Brady Dr, Colorado Springs, CO 80917-4021 | 2011-10-06 |
| 1588996243 | Luke William Willis | Military Health Care Provider | 1965 Shawnee Dr, Colorado Springs, CO 80915-1920 | 2010-02-05 |
| 1932342094 | Daniel Luther Green IIi | Military Health Care Provider | 1 Norad Rd, Colorado Springs, CO 80914-6001 | 2009-04-19 |
| 1316587116 | Cori Lea Andrews | Military Health Care Provider | 559 Vincent St Bldg 959, Colorado Springs, CO 80914-1541 | 2020-01-09 |
| 1700013380 | Curtis E Clawson | Military Health Care Provider | 1 Norad Rd, Suite 1205, Colorado Springs, CO 80906 | 2009-06-22 |
| 1740417641 | David Andrew Holman | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-06-18 |
| 1386879633 | Edward L Nelson Jr. | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-05-15 |
| 1386887792 | Jovonne D Parnell | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-04-15 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80914 |
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| 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.