Peter Charles Grosso, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101042222 Issued in VA

Practice address

1005 Commercial Lane
Godwin BLDG on RT 10, Suite 220
Suffolk, VA 23434-8149

Phone

(757) 668-2600

Fax

(757) 668-2620

NPI assigned

Apr 22, 2006

Last updated

Dec 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1144286832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 COMMERCIAL LANE",
            "address_2": "GODWIN BLDG ON RT 10, SUITE 220",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348149",
            "telephone_number": "757-668-2600",
            "fax_number": "757-668-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 COMMERCIAL LANE",
            "address_2": "GODWIN BLDG ON RT 10, SUITE 220",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348149",
            "telephone_number": "757-668-2600",
            "fax_number": "757-668-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSO",
        "first_name": "PETER",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101042222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6746209",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890583W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.