Walter J Gruber, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

WG038289 Issued in MI

Practice address

555 W Wackerly Street
Suite 1500
Midland, MI 48640-4712

Phone

(989) 631-8300

Fax

(989) 839-8170

NPI assigned

Jul 17, 2006

Last updated

Oct 26, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: walter.gruber@wgruber.ssdirect.aprima.com

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1164440277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY ST",
            "address_2": "SUITE 1500",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404722",
            "telephone_number": "989-631-8300",
            "fax_number": "989-839-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY STREET",
            "address_2": "SUITE 1500",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404712",
            "telephone_number": "989-631-8300",
            "fax_number": "989-839-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "WALTER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "WG038289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2096083",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCR LICENSE NUMBER",
            "identifier": "WG038289",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dean Grimason
• Charra Grist
• Debora Grostick
• Kenneth Eugene Grove Jr., D.D.S.
• Growing Minds Therapy Co PLLC
• Charles A Guidot, MD
• Joshuah Edward Guigar, NURSE PRACTITIONER
• Kaeyla Gullett
• Kylee E Gulliver, ATC
• Ximena Elizabeth Gumpel, PA-C

• Internal Medicine Physician in Midland, MI
• Providers in Midland, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.