Lorraine Gwen Grube, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1516 Issued in CO

Practice address

412 North C Street
Cripple Creek, CO 80813

Phone

(719) 200-9668

NPI assigned

Oct 25, 2005

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Health Stop LLC

  • Clinic/Center
  • Aurora, CO
  • NPI 1649329830
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1184614828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD",
            "address_2": "SUITE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175101",
            "telephone_number": "719-632-5700",
            "fax_number": "719-344-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 NORTH C STREET",
            "city": "CRIPPLE CREEK",
            "state": "CO",
            "postal_code": "80813",
            "telephone_number": "719-200-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBE",
        "first_name": "LORRAINE",
        "middle_name": "GWEN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44985738",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catholic Health Initiatives Colorado
• County of Teller School District Re1
• Diversus Health Inc
• Diversus Health Inc
• Gorman Medical LLC
• Robin R Halper, LPC
• Ambyr Dawn Hodkins, FNP-C
• JMJ III
• Kurt a Wever MD PC
• Nicole Leadley, DDS

• Medical Physician Assistant in Cripple Creek, CO
• Providers in Cripple Creek, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.