DR. DYLAN GRIMARD DO
NPI 1093643959
Student in an Organized Health Care Education/Training Program in Charleston, WV

Q: What is Dylan Grimard's NPI number?

The NPI number for Dylan Grimard is 1093643959. It was assigned to this individual provider in the NPPES registry on May 11, 2026.

Q: What is Dylan Grimard's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Dylan Grimard was last updated on May 11, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 11, 2026PECOS Enrolled

3200 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 388-5432 Get Directions Write a Review

NPPES record last updated: May 11, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Dylan Grimard Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DYLAN GRIMARD DO (NPI 1093643959) is an individual student in an organized health care education/training program in Charleston, West Virginia and active in the NPI registry since May 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093643959

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. DYLAN GRIMARDCredential: DO

Location Address3200 MACCORKLE AVE SECharleston, WV 25304-1227

Mailing Address3200 Maccorkle Ave SeCharleston, WV 25304-1227

Phone(304) 388-5432

Sole ProprietorYes

Enumeration DateMay 11, 2026

NPPES CertifiedMay 11, 2026

✔ NPI 1093643959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3200 MACCORKLE AVE SE, Charleston, WV 25304

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dylan Grimard Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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