Individual provider Active NPI

Ann Groce, MD

  • Anesthesiology Physician
  • Kingsport, TN
National Provider Identifier
1043202443
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
13080 Issued in TN
Practice address
135 W Ravine Rd
Ste 5B
Kingsport, TN 37660-3847
Phone
(423) 224-3460
Fax
(423) 224-3465
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 13080 TN Primary

Addresses

Primary practice location

135 W Ravine Rd
Ste 5B
Kingsport, TN 37660-3847

Mailing address

PO Box 1308
Kingsport, TN 37662-1308
Phone (423) 224-3460

Other identifiers 10

IdentifierTypeStateIssuer
050011789OtherRAILROAD MEDICARE
TN0100OtherJOHN DEER
3183511MedicaidTN
5747643MedicaidVA
100010283OtherPHP TENNCARE
5900464MedicaidNC
64775992MedicaidKY
3046933OtherBLUE SHIELD OF TN
063141OtherANTHEM BCBS
00013859OtherNHC CARE ADMINISTRATORS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13080TNMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Group of Tennessee, P. C. Anesthesiology PastSince Oct 1, 2012 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1043202443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1308",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376621308",
            "telephone_number": "423-224-3460",
            "fax_number": "423-224-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W RAVINE RD",
            "address_2": "STE 5B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603847",
            "telephone_number": "423-224-3460",
            "fax_number": "423-224-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROCE",
        "first_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "13080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050011789",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEER",
            "identifier": "TN0100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3183511",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5747643",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100010283",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900464",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64775992",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF TN",
            "identifier": "3046933",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "063141",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHC CARE ADMINISTRATORS",
            "identifier": "00013859",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.