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JOHNATHAN GRIMES
NPI 1174317093
Student in an Organized Health Care Education/Training Program in Gainesville, GA

Active since April 07, 2025PECOS Enrolled
1075 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501(770) 219-5407(770) 219-8369 Get Directions Write a Review

NPPES record last updated: April 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Johnathan Grimes NPPES

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

JOHNATHAN GRIMES (NPI 1174317093) is an individual student in an organized health care education/training program in Gainesville, Georgia and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174317093
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJOHNATHAN GRIMES
Location Address1075 JESSE JEWELL PKWY SEGainesville, GA 30501
Mailing Address743 Spring St Ne Ste 710Gainesville, GA 30501-3715 · (770) 219-8730
Phone(770) 219-5407
Fax(770) 219-8369
Sole ProprietorNo
Enumeration DateApril 7, 2025
NPPES CertifiedApril 2, 2025
✔ NPI 1174317093 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.
1075 JESSE JEWELL PKWY SE, Gainesville, GA 30501
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johnathan Grimes 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.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SALANKARA BANDYOPADHYAY
Student in an Organized Health Care Education/Training Program
1075 JESSE JEWELL PKWY SE
GAINESVILLE, GA 30501
Hall County (770) 219-5407
RACHEL A YANEV
Student in an Organized Health Care Education/Training Program
1075 JESSE JEWELL PKWY SE
GAINESVILLE, GA 30501
Hall County (770) 219-5407
DR. ZUHAAB MIRZA TEMURI MD
Student in an Organized Health Care Education/Training Program
1075 JESSE JEWELL PKWY SE
GAINESVILLE, GA 30501
Hall County (770) 219-8369
JOE HENRY WILLIAMS JR. DO
Student in an Organized Health Care Education/Training Program
1075 JESSE JEWELL PKWY SE
GAINESVILLE, GA 30501
Hall County (770) 219-5407
DR. KAFAYAT OKETADE MD
Student in an Organized Health Care Education/Training Program
1075 JESSE JEWELL PKWY SE
GAINESVILLE, GA 30501
Hall County (770) 219-5407
NATHANIEL WILLIAM CLEM
Student in an Organized Health Care Education/Training Program
1075 JESSE JEWELL PKWY SE
GAINESVILLE, GA 30501
Hall County (770) 219-8369
KARAN SONI
Student in an Organized Health Care Education/Training Program
1075 JESSE JEWELL PKWY SE
GAINESVILLE, GA 30501
Hall County (770) 219-5407

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johnathan Grimes's NPI number?

The NPI number for Johnathan Grimes is 1174317093. It was assigned to this individual provider in the NPPES registry on April 7, 2025.

Where is Johnathan Grimes located?

Johnathan Grimes practices at 1075 Jesse Jewell Pkwy SE, Gainesville, GA 30501. The listed phone number is (770) 219-5407.

What is Johnathan Grimes's specialty?

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

Is Johnathan Grimes enrolled in Medicare?

Yes. Johnathan Grimes is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Johnathan Grimes was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.