Active NPI
Jonathan C Groh, M.D.
- Internal Medicine Physician
- Orange Park, FL
National Provider Identifier
1144209768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 22114
- Practice address
- 1700 Covington LN
Orange Park, FL 32003-3378 - Phone
- (240) 994-8118
- NPI assigned
- Jan 12, 2006
- Last updated
- Apr 3, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 22114 | AL | Primary |
Addresses
Primary practice location
1700 Covington LN
Orange Park, FL 32003-3378
Mailing address
1700 Covington LN
Orange Park, FL 32003-3378
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22114 | AL | MD | Internal Medicine Physician |
Interoperability endpoints
- jonathan.groh.1@14027.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207180800000",
"number": "1144209768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 COVINGTON LN",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320033378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 COVINGTON LN",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320033378",
"telephone_number": "240-994-8118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROH",
"first_name": "JONATHAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2008-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AL",
"license": "22114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.