CAROL JEAN GRIMM (NPI# 1558389106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558389106 |
| Entity Type | Individual |
| Full Name | CAROL JEAN GRIMM |
| Credential | MD |
| Practice Address |
801 Broadway N Fargo ND 58102-3641 |
| Practice Telephone | 7012344811 |
| Practice Fax Number | 7012346979 |
| Mailing Telephone | 7012342397 |
| Mailing Fax Number | 7012343861 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2012-01-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
5501 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 680387300 | 05 | |
| ND | 15677 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215575436 | Carol S Grimm | Nurse Practitioner | 5702 Bridgetown Rd Apt 8, Street Address 2, Cincinnati, OH 45248 | 2019-12-18 |
| 1801998364 | Carol Deborah Grimm | Dentist | 2999 Regent St, Suite 403, Berkeley, CA 94705-2146 | 2006-09-03 |
| Street Address |
801 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-3641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528062924 | Mark F Fisher | Radiology | 801 Broadway N, Fargo, ND 58102-3641 | 2005-06-13 |
| 1942809652 | Morgan Margaret Borud | Nurse Practitioner | 801 Broadway N, Fargo, ND 58102-3641 | 2020-10-22 |
| 1790392462 | Katie Thielges | Nurse Practitioner | 801 Broadway N, Fargo, ND 58102-3641 | 2020-09-28 |
| 1063022432 | Lindsey Schmidt | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2020-07-31 |
| 1336766161 | Yesha Shukla | Family Medicine | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-27 |
| 1891310850 | Samantha Mimi Chang | Family Medicine | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-15 |
| 1528683224 | Briana Lee Gebert-oberle | Student in an Organized Health Care Education/Training Program | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-09 |
| 1689296931 | Jillian Virginia Schommer | Student in an Organized Health Care Education/Training Program | 801 Broadway N, Fargo, ND 58102-3641 | 2020-05-09 |
| 1194344036 | Sarah Rose Carpenter | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2020-04-10 |
| 1346871258 | Randall Hagemeister | Nurse Anesthetist, Certified Registered | 801 Broadway N, Fargo, ND 58102-3641 | 2020-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124053285 | Preston D Steen | Internal Medicine | 820 4th Street North, Fargo, ND 58122-0001 | 2006-07-11 |
| 1245551134 | Tadeu F Ambros | Internal Medicine | 1702 University Dr S, Fargo, ND 58103-4940 | 2010-06-15 |
| 1659477354 | Eugene Joseph Tilchen | Internal Medicine | 2101 Elm St N, Fargo, ND 58102-2417 | 2006-09-16 |
| 1669494209 | Denise Suzanne Snow | Internal Medicine | 820 4th St N, Fargo, ND 58122-0001 | 2006-07-24 |
| 1811914583 | John M Leitch | Internal Medicine | 820 4th St N, Fargo, ND 58122-0001 | 2006-07-17 |
| 1548287212 | Ralph Levitt | Internal Medicine | 820 4th St N, Fargo, ND 58102-4539 | 2006-07-17 |
| 1225073661 | Mark Mutuota Gitau | Internal Medicine | 737 Broadway, Fargo, ND 58122-0001 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134147713 | Ngozi O Nwakamma-okoro | Internal Medicine | 960 S Columbia Rd - Altru Cancer Center, Grand Forks, ND 58201 | 2006-07-18 |
| 1366416737 | Sanford Clinic North | Internal Medicine | 420 South 7th Street, Oakes, ND 58474-2024 | 2006-02-14 |
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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.