Kevin N Groom, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY6326 Issued in FL

Practice address

890 South Palafox Street
Suite 300
Pensacola, FL 32502

Phone

(850) 433-1656

Fax

(850) 433-1996

NPI assigned

Oct 2, 2006

Last updated

Jul 19, 2023By 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 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL, AL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Anchor Clinic LLCGroup PAC ID 8729183512, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• The Anchor Clinic, LLC

  dba Anchor Clinic

  • Health Service Psychologist
  • Pensacola, FL
  • NPI 1629161435

  AL

  Medicare reassignment Care Compare group Authorized official
• Anchor Multispecialty Group

  • Multi-Specialty Clinic/Center
  • Pensacola, FL
  • NPI 1194371963
  NPD Authorized official
• Anchor Multispecialty Group

  • Neurology Physician
  • Pensacola, FL
  • NPI 1528627882

  Clinical Neuropsychologist

  NPD Authorized official
• Pensacola Psychological Clinic PA

  • Clinical Psychologist
  • Pensacola, FL
  • NPI 1730241209
  NPD (past) Authorized official
• The Anchor Clinic, LLC

  • Psychiatric/Mental Health Registered Nurse
  • Navarre, FL
  • NPI 1013367549
  Authorized official Same address or phone
• The Anchor Clinic, LLC

  • Occupational Therapist
  • Pensacola, FL
  • NPI 1982994281
  Authorized official Same address or phone

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1184717027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 SOUTH PALAFOX STREET",
            "address_2": "SUITE 300",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32502",
            "telephone_number": "850-433-1656",
            "fax_number": "850-433-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 SOUTH PALAFOX STREET",
            "address_2": "SUITE 300",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32502",
            "telephone_number": "850-433-1656",
            "fax_number": "850-433-1996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Professional Park Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Fairhope",
            "state": "AL",
            "postal_code": "365321943",
            "country_code": "US",
            "telephone_number": "850-433-1656",
            "fax_number": "850-433-1996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7552 Navarre Pkwy Unit 61",
            "address_purpose": "LOCATION",
            "city": "Navarre",
            "state": "FL",
            "postal_code": "325667305",
            "country_code": "US",
            "telephone_number": "850-684-3884",
            "fax_number": "850-433-1996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROOM",
        "first_name": "KEVIN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY6326",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AL",
            "license": "1138",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "54648",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL  DOTHAN AL",
            "identifier": "510-01535",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL GROUP",
            "identifier": "59033603",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth Anne Grissom, MD
• Samuel Grissom, M.D.
• Desirea Rose Grochola, HAS
• Elliot Groff, DO
• Jason Gronert, MD
• Pashia D Groom, PHD
• Caitlin Reichle Gross, MS.CCC-SLP
• Jessie Enrique Gross, PA
• William Elsworth Gross, MD
• Skyelar Grosvenor, RBT

• Clinical Neuropsychologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.