Individual provider Active NPI

Melissa Grow

  • Licensed Practical Nurse
  • Springfield, OH
National Provider Identifier
1043903149
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
119249 Issued in OH
Practice address
287 E. Leffel Lane
Springfield, OH 45505
Phone
(937) 360-1764
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 119249 OH Primary

Addresses

Primary practice location

287 E. Leffel Lane
Springfield, OH 45505

Mailing address

287 E. Leffel Lane
Springfield, OH 45505
Phone (937) 360-1764

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
119249OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Treatment Centers Oh-Xviii, LLC CurrentSince Jun 4, 2023 Accepting new patients

Locations

287 E Leffel Ln
Springfield, OH 45505
Phone (937) 342-3041

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1043903149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 E. LEFFEL LANE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45505",
            "telephone_number": "937-360-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 E. LEFFEL LANE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45505",
            "telephone_number": "937-360-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROW",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "119249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.