Individual provider Active NPI

Rosanne R Griggs, FNP

  • Family Nurse Practitioner
  • Wolcott, IN
National Provider Identifier
1013029552
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
134726 Issued in MO
Practice address
128 W Market St
Wolcott, IN 47995-8130
Phone
(219) 747-2067
Fax
(219) 747-2068
NPI assigned
Aug 31, 2006
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 71003082 IN
Family Nurse Practitioner 363LF0000X 134726 MO Primary

Addresses

Primary practice location

128 W Market St
Wolcott, IN 47995-8130

Mailing address

104 Chateau Dr
Fairview Heights, IL 62208-3611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181227001576 IN Order and Referring Only - Nurse Practitioner 5597867093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
134726MOMDFamily Nurse Practitioner
71003082INMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Purdue University Past Accepting new patients
Trustees of Purdue University Past Accepting new patients
Trustees of Purdue University Past Accepting new patients
Trustees of Purdue University Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1013029552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CHATEAU DR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W MARKET ST",
            "city": "WOLCOTT",
            "state": "IN",
            "postal_code": "479958130",
            "telephone_number": "219-747-2067",
            "fax_number": "219-747-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGGS",
        "first_name": "ROSANNE",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71003082",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "134726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolcott, IN

Sources for this page

Verify at the official NPI Registry.