MEDICARE: DR. JAMES M GRIMES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME68197	FL
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	ME68197	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	OV803	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1174540001	OTHER	FL	DMERC
2	1174540001	OTHER	FL	CIGNA GOVT SVCS DMERC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689644833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES M GRIMES MD

Provider Business Mailing Address
First Line	:	PO BOX 3266
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32085-3266
Country	:	US
Telephone Number	:	904-819-4602
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 PLANTATION ISLAND DR S STE 106A
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32080-3109
Country	:	US
Telephone Number	:	904-814-8365
Fax Number	:	904-217-3224

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	04/01/2024

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Directions to “ DR. JAMES M GRIMES MD” Practice Location

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