NPIMap

Organization Active NPI

Ronald E Grow Inc

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1013117472
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02000101A Issued in IN
Legal business name
RONALD E GROW INC
Practice address
810 W Indiana Ave
South Bend, IN 46613-1828
Phone
(574) 289-5049
Fax
(574) 288-0840
NPI assigned
Jul 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Authorized official

Name
Dr. Ronald E Grow, DO
Title
Owner
Phone
(574) 289-5049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 02000101A IN Primary

Addresses

Primary practice location

810 W Indiana Ave
South Bend, IN 46613-1828

Mailing address

810 W Indiana Ave
South Bend, IN 46613-1828
Phone (574) 289-5049

National Provider Directory

National Provider Directory

Locations

810 W Indiana Ave
South Bend, IN 46613
Phone (574) 288-5049

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1013117472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W INDIANA AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466131828",
            "telephone_number": "574-289-5049",
            "fax_number": "574-288-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W INDIANA AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466131828",
            "telephone_number": "574-289-5049",
            "fax_number": "574-288-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD E GROW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "GROW",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-289-5049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02000101A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.