Physician Compare National (NPI:1881709301)

HEALTHCARE PROVIDER: GERALD W GRIM MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1881709301
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9931262144
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090114000695
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRIM
	Individual professional last name
Provider First Name	GERALD
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1976
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MARSHFIELD CLINIC INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	2264345206
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	758
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4100 STATE HWY 66
	Group Practice or individual's line 1 address
City	STEVENS POINT
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	544828410
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7153437700
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y