MR. MAHLON DAVID GRIMSLEY (NPI# 1114963691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114963691 |
Entity Type | Individual |
Full Name | MR. MAHLON DAVID GRIMSLEY |
Credential | PA |
Practice Address |
1824 Hillandale Rd Durham NC 27705-2650 |
Mailing Address |
4415 Angier Ave Durham NC 27703-5803 |
Practice Telephone | 9199577862 |
Mailing Telephone | 9199577862 |
Enumeration Date | 2006-06-21 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCCPA # | 1021201 | 01 |
Street Address |
1824 HILLANDALE RD |
City | DURHAM |
State | NC |
Zip Code | 27705-2650 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982666046 | Carol Dashner Mcmorrow | Physician Assistant | 1824 Hillandale Rd, Durham, NC 27705-2650 | 2006-04-04 |
1477029163 | Stephanie Jean Tisdal | Nurse Practitioner | 1824 Hillandale Rd, Durham, NC 27705-2650 | 2018-10-19 |
1013324110 | Durham Vamc | Clinic/Center | 1824 Hillandale Rd, Durham, NC 27705-2650 | 2014-07-21 |
1376779793 | Donald R Murphy Jr. | Family Medicine | 1824 Hillandale Rd, Vamc, Durham, NC 27705 | 2009-06-01 |
1902007198 | Nicole Nilmeier Grant | Internal Medicine | 1824 Hillandale Rd, Va Medical Center, Durham, NC 27705-2650 | 2007-05-29 |
1528168572 | Lori Ann Orlando | Internal Medicine | 1824 Hillandale Rd, Durham, NC 27705-2650 | 2006-09-22 |
1528174240 | Jenny Rebecca Legge | Pharmacist | 1824 Hillandale Rd, Durham, NC 27705-2650 | 2006-08-23 |
1285683961 | Thomas Finley Newcomb | Internal Medicine | 1824 Hillandale Rd, Durham, NC 27705-2650 | 2006-05-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
Find all providers in zip 27705 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083197651 | Erika Cummings | Physician Assistant | 40 Medicine Circle Clinic 1l Duke South Clinic Bldg, Durham, NC 27710-2102 | 2018-09-10 |
1396237566 | Sarah Elizabeth Beatty | Physician Assistant | 1317 Southpoint Crossing Dr, Durham, NC 27713 | 2018-06-04 |
1225548704 | Lindsey Anna Rowe | Physician Assistant | 2301 Erwin Road Duke North Suite 2600, Room 2607a, Durham, NC 27710-0001 | 2017-10-10 |
1801316831 | Stefanie Nikoloas Xenakis | Physician Assistant | 2400 Broad St Ste 1, Durham, NC 27704-2662 | 2017-06-21 |
1861842700 | Kelly Michelle Young | Physician Assistant | 2424 Erwin Rd Ste 201, Durham, NC 27705-3825 | 2016-06-21 |
1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
1033589577 | Andrew David Mcgraw | Physician Assistant | Duke University Medical Center Emergency, 2nd Floor 2301 Erwin Road Durham, Nc 27710, Durham, NC 27710-4699 | 2015-09-27 |
1093145443 | Catherine Casey Mcknight | Physician Assistant | 3458 Duke University Medical Center, Durham, NC 27710 | 2013-11-21 |
1013343490 | Carolyn Chyu Tashie | Physician Assistant | Duke Cancer Center 20 Duke Medicine Circle Clinic 3-2, Durham, NC 27710-4699 | 2013-09-18 |
1477817203 | Andrew Robert Macknair | Physician Assistant | 4225 Larchmont Rd, Apt 1021, Durham, NC 27707-5962 | 2012-06-26 |
Find all providers in DURHAM |
Please comment or provide details below to improve the information on MR. MAHLON DAVID GRIMSLEY.
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.