Mallory Williams Grose, ANP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5005508 Issued in NC

Practice address

694 Riverside Dr
Mount Airy, NC 27030

Phone

(336) 719-7892

Fax

(336) 719-7898

NPI assigned

Mar 1, 2012

Last updated

Aug 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
• Northern Regional Hospital Hospital, Mount Airy, NC, CCN 340003

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgrose497079@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• BRMG-PC

  • Cardiovascular Disease Physician
  • Elkin, NC
  • NPI 1477985430
  NPD
• Forsyth Memorial Hospital Inc

  dba Novant Health Forsyth Family Medicine

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1033488358
  NPD
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Heart & Vascular Institute - Frontis Plaza

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Medical Group, Inc

  dba Novant Health Orthopedics & Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Salisbury, NC
  • NPI 1841616950
  NPD
• Forsyth Memorial Hospital, Inc

  dba Novant Health Surry Medical Associates

  • Family Medicine Physician
  • Mount Airy, NC
  • NPI 1295783108
  NPD (past)
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Northern Hospital of Surry County

  dba North Hospital of Surry County

  • General Acute Care Hospital
  • Mount Airy, NC
  • NPI 1366449282
  Care Compare affiliation

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1093089575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-719-7892",
            "fax_number": "336-719-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 RIVERSIDE DR",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "27030",
            "telephone_number": "336-719-7892",
            "fax_number": "336-719-7898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 ROCKFORD ST",
            "address_purpose": "LOCATION",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305323",
            "country_code": "US",
            "telephone_number": "336-719-2440",
            "fax_number": "336-719-6915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 ROCKFORD ST",
            "address_purpose": "LOCATION",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305323",
            "country_code": "US",
            "telephone_number": "336-719-2440",
            "fax_number": "336-719-6915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSE",
        "first_name": "MALLORY",
        "middle_name": "WILLIAMS",
        "name_prefix": "Mrs.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5005508",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "363LA2200X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrose497079@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "905 ROCKFORD ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270305323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Renee Lynn Guertin
• Jennifer Leigh Guyer, PHARMD

• Nurse Practitioner in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.