Individual provider Active NPI

Madeline Ann Gronotte

  • School Psychologist
  • Kettering, OH
National Provider Identifier
1063928034
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
580 Lincoln Park Blvd Ste 105
Kettering, OH 45429-3556
Phone
(937) 499-1435
NPI assigned
Dec 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X Primary

Addresses

Primary practice location

580 Lincoln Park Blvd Ste 105
Kettering, OH 45429-3556

Mailing address

580 Lincoln Park Blvd Ste 105
Kettering, OH 45429-3556
Phone (937) 499-1435

Other identifiers 1

IdentifierTypeStateIssuer
2846675MedicaidOH

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering City School District CurrentSince Aug 18, 2024 Accepting new patients

Locations

580 Lincoln Park Blvd
Ste 105
Kettering, OH 45429
Phone (937) 499-1400

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": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1063928034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 LINCOLN PARK BLVD STE 105",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293556",
            "telephone_number": "937-499-1435",
            "fax_number": "937-499-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 LINCOLN PARK BLVD STE 105",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293556",
            "telephone_number": "937-499-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONOTTE",
        "first_name": "MADELINE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.