Jan C Gromada DO Facoog PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

5101006098 Issued in MI

Legal business name

JAN C GROMADA DO FACOOG PLLC

Practice address

420 W Nepessing St
Lapeer, MI 48446-2150

Phone

(810) 245-9011

Fax

(810) 245-9012

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Jan C Gromada, DO

Title

Owner

Phone

(810) 245-9011

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1073678561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W NEPESSING ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484462150",
            "telephone_number": "810-245-9011",
            "fax_number": "810-245-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W NEPESSING ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484462150",
            "telephone_number": "810-245-9011",
            "fax_number": "810-245-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN C GROMADA DO FACOOG PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GROMADA",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-245-9011",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101006098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5101006098",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.