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Deactivated NPI 1831440122 Deactivated / Inactive NPI Female Practitioner

Stacey Grimes , CRNP

Nurse Practitioner • Warren, PA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Stacey Grimes has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 26, 2012
NPI Deactivation Date October 28, 2019
Total Practice Duration ~7 Years of Practice (2012 – 2019)

Professional Overview & Biography Verified Profile Summary

Stacey Grimes, CRNP was a registered Nurse Practitioner practicing in Warren, PA. Throughout an active medical career spanning 7 years, Stacey Grimes provided care at the practice location at 2 W CRESCENT PARK until profile deactivation on 2019-10-28.

Practice Location & Contact Primary Location

Practice Address

2 W Crescent Park

Warren, PA 163652111

Telephone 8147233300
Fax 8147269412
Associated Practice Facility / Clinic
🏢 Renal Care Of Warren, Llc Facility NPI 1720072093

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Warren, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.1 Yrs
State Avg: 10.7 Yrs
Regional Practice Density
9 Specialists

Practicing in Warren, PA (3955 Statewide)

Telehealth Adoption Rate
11.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License NY 337336

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Chad Ristau

Nurse Anesthetist, Certified Registered

NPI 1013187558
NPI 1013786821

Doctor of Pharmacy (Pharm.D.)

Dr. Manu Kaushik , MD

Family Medicine

NPI 1053642140

Doctor of Medicine (M.D.)

Melissa Eckman , NP-C

Nurse Practitioner

NPI 1053863191

Nurse Practitioner (Certified)

Dr. Douglas Megill , MD

Emergency Medicine

NPI 1083603310

Doctor of Medicine (M.D.)

Kelly Sullivan , CRNP

Nurse Practitioner - Family

NPI 1114392735

Certified Registered Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 28, 2019

Record deactivated on October 28, 2019

NPI Profile Active February 09, 2016

NPI status registered as active in NPPES database

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Updated Practice Location February 09, 2016

Registered at 2 W CRESCENT PARK, WARREN, PA 163652111 (Tel: 8147233300)

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Updated Business Mailing Address February 09, 2016

Registered at 2 W CRESCENT PARK, WARREN, PA 163652111 (Tel: 8147233300)

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Provider Name / Credentials Updated February 09, 2016

Recorded as STACEY GRIMES, CRNP

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 09, 2016

Nurse Practitioner (License #337336 in NY)

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Initial NPI Registration & Enumeration September 26, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1831440122
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 26, 2012
Last Update: February 09, 2016
Deactivation Date: October 28, 2019

Mailing Address

2 W Crescent Park

Warren, PA 163652111

Phone: 8147233300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.