Active NPI
Suzanne M Grove, ARNP
- Family Nurse Practitioner
- Pomeroy, WA
National Provider Identifier
1124127071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP30000968
- Practice address
- 66 N 6TH St
Pomeroy, WA 99347-9705 - Phone
- (509) 843-1591
- Fax
- (509) 843-1234
- NPI assigned
- Sep 21, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP30000968 | WA | Primary |
Addresses
Primary practice location
66 N 6TH St
Pomeroy, WA 99347-9705
Mailing address
66 N 6TH St
Pomeroy, WA 99347-9705
Phone (509) 843-1591
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9604000 | Medicaid | WA | |
| 805880200 | Other | ID | ID DSHS |
| GAB03061 | Other | WA | MEDICARE PTAN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278979200000",
"number": "1124127071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 N 6TH ST",
"city": "POMEROY",
"state": "WA",
"postal_code": "993479705",
"telephone_number": "509-843-1591",
"fax_number": "509-843-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 N 6TH ST",
"city": "POMEROY",
"state": "WA",
"postal_code": "993479705",
"telephone_number": "509-843-1591",
"fax_number": "509-843-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROVE",
"first_name": "SUZANNE",
"middle_name": "M",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2010-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP30000968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9604000",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ID DSHS",
"identifier": "805880200",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "GAB03061",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pomeroy, WA
- Garfield County Memorial Hospital District
- Garfield County Memorial Hospital District
- Garfield County Memorial Hospital District
- Garfield County Memorial Hospital Radiology
- Garfield County Public Hospital District #1
- Jonathan Harker, PT
- Steven John Jackson, LMT
- Natalie Kirksey, MSW
- Janique Jade Lakey, NA
- Brian Alan Mabry, BRIAN MABRY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.