MATTHEW GRIMM (NPI# 1861015992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861015992 |
| Entity Type | Individual |
| Full Name | MATTHEW GRIMM |
| Credential | FNP-BC |
| Practice Address |
1526 Bridgewater Ln Kingsport TN 37660-4106 |
| Mailing Address |
146 Clearview St Gray TN 37615-3628 |
| Practice Telephone | 4232460033 |
| Enumeration Date | 2020-05-23 |
| Last Update Date | 2020-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
27586 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518383603 | Matthew Grimm | Social Worker | 1025 E Forest Ave, Detroit, MI 48207-1024 | 2014-03-13 |
| 1457785503 | Matthew Edward Grimm | Massage Therapist | 1312 Vandercook Way, Longview, WA 98632-3902 | 2013-08-26 |
| 1437472123 | Matthew Grimm | Pharmacist | 3175 Chili Ave, Rochester, NY 14624-5423 | 2010-03-09 |
| 1275732745 | Matthew P. Grimm | Physical Medicine & Rehabilitation | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2007-07-16 |
| 1255359287 | Matthew William Grimm | Physical Therapist | 11840 Southmore Dr, Suite 100, Charlotte, NC 28277-4466 | 2006-07-17 |
| 1407806748 | Matthew R Grimm | Orthopaedic Surgery | 920 Avenue B, Marrero, LA 70072-3112 | 2006-05-10 |
| Street Address |
1526 BRIDGEWATER LN |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285664839 | Scott D Mclain | Family Medicine | 1526 Bridgewater Ln, Kingsport, TN 37660-4106 | 2006-07-03 |
| 1679074892 | Kingsport Primary Healthcare, LLC | Family Medicine | 1526 Bridgewater Ln, Kingsport, TN 37660-4106 | 2018-02-22 |
| 1023186145 | Kingsport Primary Care, PC | Clinic/Center | 1526 Bridgewater Ln, Kingsport, TN 37660-4106 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750911202 | Felicia Grace Berry | Nurse Practitioner | 2204 Pavilion Dr Ste 210, Kingsport, TN 37660-4652 | 2020-01-23 |
| 1205399508 | Michael David Thacker | Nurse Practitioner | 100 Clinchfield St, Kingsport, TN 37660-3681 | 2019-04-12 |
| 1871058263 | Lisa Marie Ketchem | Nurse Practitioner | 5039 Andrew St, Kingsport, TN 37660-6500 | 2019-02-10 |
| 1972067395 | Alice Victoria Lilly | Nurse Practitioner | 2995 Ft. Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-30 |
| 1720542376 | Amanda Michelle Oliver | Nurse Practitioner | 404 Manor Dr Apt F, Kingsport, TN 37660-3471 | 2019-01-29 |
| 1750857439 | Ashlee Fleming | Nurse Practitioner | 105 W Stone Dr Ste 4c, Kingsport, TN 37660-3365 | 2018-10-19 |
| 1497220214 | Melanie Creppel Bourgeois | Nurse Practitioner | 4606 Sundown Dr, Kingsport, TN 37664-6913 | 2018-10-08 |
| 1013493147 | Cathy A Greenwood | Nurse Practitioner | 3136 Winesap Rd, Kingsport, TN 37663-2920 | 2018-07-11 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1235641630 | Bethany Monique Rock | Nurse Practitioner | 3716 Thorngrove Dr, Kingsport, TN 37660-2243 | 2017-10-26 |
| Find all providers in KINGSPORT | ||||
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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.