Andrea Lynne Grooms, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5109 Issued in TN

Practice address

570 W. Sam Ridley Prkwy
Suite 102
Smyrna, TN 37167

Phone

(615) 984-2940

Fax

(614) 984-2945

NPI assigned

Feb 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Ms. Andrea Drake Drake Former name

Medicare fee-for-service enrollment

Enrolled in PA, TN, FL3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care Enterprise LLCGroup PAC ID 5496998155, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Urgent Care Enterprise LLC

  • Urgent Care Clinic/Center
  • Antioch, TN
  • NPI 1477087658
  Medicare reassignment Care Compare group
• Patient First Pennsylvania Medical Group PLLC

  • Urgent Care Clinic/Center
  • Glen Allen, VA
  • NPI 1194039560

  PA

  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment
• MD Now Medical Centers Inc

  • Urgent Care Clinic/Center
  • West Palm Beach, FL
  • NPI 1033195474
  Medicare reassignment
• Geisinger Clinic

  • Family Medicine Physician
  • Olyphant, PA
  • NPI 1134536535
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Patient First Pennsylvania Medical Group PLLC

  • Family Medicine Physician
  • Fairless Hills, PA
  • NPI 1144870387
  NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  NPD (past)
• Lewisburg Cancer Center LLC

  • Specialist
  • Lewisburg, PA
  • NPI 1952321473
  NPD (past)
• Poonam Srivastava MD PC

  • Hematology & Oncology Physician
  • Selinsgrove, PA
  • NPI 1467474726
  NPD (past)
• Susquehanna Physician Services

  • Radiology Clinic/Center
  • Mansfield, PA
  • NPI 1073361564
  NPD (past)
• Susquehanna Physician Services

  • Otolaryngology Physician
  • Williamsport, PA
  • NPI 1346263266

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1023084019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 W. SAM RIDLEY PRKWY",
            "address_2": "SUITE 102",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "37167",
            "telephone_number": "615-984-2940",
            "fax_number": "614-984-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 W. SAM RIDLEY PRKWY",
            "address_2": "SUITE 102",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "37167",
            "telephone_number": "615-984-2940",
            "fax_number": "614-984-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOMS",
        "first_name": "ANDREA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0000860",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051040",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5109",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051040",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA003670",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "5109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023084019",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DRAKE",
            "middle_name": "DRAKE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lashonda R Greenwood, PSY.D.
• Rachel Cathryn Greer
• Ardayzsia Griffin
• Daniel Joseph Griffith, P.T.
• Rachel Marie Griggs, MS CCC SLP
• Courtney Gruzinsky
• Hope Gurley, DDS
• Morgan Dale Gurley, DDS
• Olivia Guse
• Amanda Guy

• Medical Physician Assistant in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.