Justin Groce, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

20598 Issued in TN

Practice address

115 Winwood Dr
Suite 105
Lebanon, TN 37087-1340

Phone

(615) 444-4126

Fax

(855) 785-2890

NPI assigned

Sep 21, 2015

Sex

Male

Sole proprietor

No

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

• Bradshaw Health, PLLC

  • Adult Health Nurse Practitioner
  • Lebanon, TN
  • NPI 1699214437

  TN

  Medicare reassignment

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1013386929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WINWOOD DR",
            "address_2": "SUITE 105",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871340",
            "telephone_number": "615-444-4126",
            "fax_number": "855-785-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WINWOOD DR",
            "address_2": "SUITE 105",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871340",
            "telephone_number": "615-444-4126",
            "fax_number": "855-785-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROCE",
        "first_name": "JUSTIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "20598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "6060213",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "P01697499",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q021233",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3306523",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "620842749",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Gregory
• William Winter Griffin, PTA
• Gavin Grimaldi, D.C.
• Jason Grindstaff, PHD, LPC-MHSP
• Jessikah Grisham, RBT
• Leslie S Grogan
• Kelly Grooms, RBT
• Sharon M. Grosch, LCSW
• Emily S Grove, DC
• Kathy Grove, NP

• All providers in Lebanon, TN
• Adult Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.