Individual provider Active NPI

Teresa D Grow, FNP-BC

  • Family Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1104056233
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024168385 Issued in VA
Practice address
5004 Southpoint Pkwy
Fredericksburg, VA 22407-2660
Phone
(540) 741-2045
Fax
(540) 741-3562
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024168385 VA Primary

Addresses

Primary practice location

5004 Southpoint Pkwy
Fredericksburg, VA 22407-2660

Mailing address

2300 Fall Hill Ave
Suite 515
Fredericksburg, VA 22401-3342
Phone (540) 741-0544

Other identifiers 1

IdentifierTypeStateIssuer
1104056233MedicaidVA

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
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Hospital Inc. Past Accepting new patients
Fall Hill Gastroenterology Associates, a Division of Maha, Inc. Past Accepting new patients
Fall Hill Gastroenterology Associates, LTD. PastSince Feb 1, 2007 Accepting new patients

Organizations & group practices 3

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": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1104056233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 FALL HILL AVE",
            "address_2": "SUITE 515",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013342",
            "telephone_number": "540-741-0544",
            "fax_number": "540-741-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 SOUTHPOINT PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072660",
            "telephone_number": "540-741-2045",
            "fax_number": "540-741-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROW",
        "first_name": "TERESA",
        "middle_name": "D",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104056233",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.