Rosanne R Griggs, FNP
Individual provider Active NPI Family Nurse Practitioner · Wolcott, IN
NPI 1013029552 · NPPES record last updated Sep 30, 2020
Key facts
- NPI
- 1013029552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 134726 (MO)
- Practice address
- 128 W Market St
Wolcott, IN 47995-8130 - Phone
- (219) 747-2067
- Fax
- (219) 747-2068
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181227001576 | IN | Order and Referring Only - Nurse Practitioner | 5597867093 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134726 | MO | MD | Family Nurse Practitioner |
| 71003082 | IN | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | 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 | |
| Trustees of Purdue University | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 71003082 | IN | |
| Family Nurse Practitioner | 363LF0000X | 134726 | MO | Yes |
Addresses
Primary practice location
128 W Market St
Wolcott, IN 47995-8130
Mailing address
104 Chateau Dr
Fairview Heights, IL 62208-3611
Other providers in Wolcott, IN
- Animal Health International, Inc.
- Julie A. Foster
- James K Shields
- Town of Wolcott
- Tri-County School Corporation
- Trustees of Purdue University
- Wolcott Family Medicine, LLC
All providers in Wolcott, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.