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One provider matched this enrollment ID.

Enrollment ID I20041118001084 resolves to a single NPI record. Open the full profile for complete detail.

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LG
NPI · 1598877805 · Active
Leander Grimm M.D.
Surgery · Southaven, Mississippi
Active
NPI
1598877805
Enrollment ID
I20041118001084
Taxonomy
208600000X
Type
Practitioner - General Surgery

Medicare enrollment

This provider holds 2 Medicare enrollments on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Secondary identifiers

Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.

Medicaid

Other

  • 4091934TN· Issued by BCBS TN PROVIDER NUMBER

Source: NPPES public registry.

ReferenceAbout Medicare Enrollment IDs

A Medicare Enrollment ID (ENRLMT_ID) is a 15-character public identifier assigned by the CMS Provider Enrollment, Chain and Ownership System (PECOS) when a provider, supplier, or organisation enrols in Medicare. Each row reflects one enrolment record: a single NPI can hold multiple enrolments across provider types, states, or supplier categories. Data here is mirrored from the quarterly public PECOS enrolment file published on data.cms.gov.