Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kristie Michelle Grimes-Mallard, RN

Individual provider Registered Nurse · NPI 1730797077

Kristie Michelle Grimes-Mallard, RN is a Nurse Practitioner in Roxbury, Massachusetts. Qualified in 2020, 6 years ago. Practices with Dimock Community Health Center, Inc, a 44-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
6
Licensed in
MA
In the registry since
2020
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

45 Dimock St
Roxbury, MA 02119-1208
Phone: (617) 442-8800
Fax: (617) 541-8334
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN2335640 (MA)
Registered Nurse Taxonomy 163W00000X · Licence RN2335640 (MA)

Record details

NPI number1730797077
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorYes
NPI enumeratedJuly 22, 2020
Last updated in NPPESNovember 16, 2020
Certification dateNovember 16, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Dimock Community Health Center, Inc. — 44 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Roxbury