Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Kristie Michelle Grimes-Mallard, RN

Individual provider Women's Health Nurse Practitioner · 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, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
6
Licensed in
MA
In the registry since
2020
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 →

Practice location Address checks out

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

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

Additional practice locations (1)

  • 736 Cambridge St, Brighton, MA 02135-2907 — (617) 562-7007

Specialties & licences

Women's Health Nurse Practitioner (primary) Taxonomy 363LW0102X · Licence RN2335640 (MA)

Record details

NPI number1730797077
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorNo
NPI enumeratedJuly 22, 2020
Last updated in NPPESSeptember 29, 2026
Certification dateSeptember 29, 2026

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

Colleagues at Dimock Community Health Center, Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 44 clinicians in the practice; 12 are shown here.

Other providers in Roxbury