Active NPI
Sallie Ebert Grundman, FNP
- Family Nurse Practitioner
- Winchester, VA
National Provider Identifier
1154538858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0017138755
- Practice address
- 301 N Cameron St
Suite 100
Winchester, VA 22601-4899 - Phone
- (540) 536-1680
- Fax
- (540) 662-5321
- NPI assigned
- May 16, 2007
- 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 | 0017138755 | VA | Primary |
Addresses
Primary practice location
301 N Cameron St
Suite 100
Winchester, VA 22601-4899
Mailing address
248 Thwaite LN
Winchester, VA 22603-3960
Phone (540) 662-7055
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 |
|---|---|---|---|
| 0017138755 | VA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154538858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 THWAITE LN",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226033960",
"telephone_number": "540-662-7055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N CAMERON ST",
"address_2": "SUITE 100",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226014899",
"telephone_number": "540-536-1680",
"fax_number": "540-662-5321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUNDMAN",
"first_name": "SALLIE",
"middle_name": "EBERT",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0017138755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winchester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.