Active NPI
Meredith Grello, PA-C
- Physician Assistant
- La Crosse, WI
National Provider Identifier
1114609344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-00256
- Practice address
- 700 3Rd St N Ste Ll7A
La Crosse, WI 54601-9303 - Phone
- (608) 394-4090
- NPI assigned
- Aug 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-00256 | NC | Primary |
Addresses
Primary practice location
700 3Rd St N Ste Ll7A
La Crosse, WI 54601-9303
Mailing address
2315 Sandside CT
Onalaska, WI 54650-9377
Phone (856) 296-8164
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-00256 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691366400000",
"number": "1114609344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2315 SANDSIDE CT",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546509377",
"telephone_number": "856-296-8164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 3RD ST N STE LL7A",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546019303",
"telephone_number": "608-394-4090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRELLO",
"first_name": "MEREDITH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-07",
"last_updated": "2023-08-07",
"certification_date": "2023-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-00256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.