Active NPI
John B Groner, MD
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Kennewick, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- License
- MD00049437
- Practice address
- 4309 W 27TH PL Ste 202
Kennewick, WA 99338-2908 - Phone
- (509) 591-4966
- Fax
- (509) 396-5033
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | 2081N0008X | MD156621 | OR | |
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | MD156621 | OR | |
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | MD00049437 | WA | Primary |
Addresses
Primary practice location
4309 W 27TH PL Ste 202
Kennewick, WA 99338-2908
Mailing address
4309 W 27TH PL Ste 202
Kennewick, WA 99338-2908
Phone (509) 591-4966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4309 W 27TH PL
Suite 202
Kennewick, WA 99338-2908
Phone (509) 591-4966
Hospital & facility affiliations
- Kadlec Regional Medical Center
- Providence St Mary Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD156621 | OR | MD | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician |
| MD00049437 | WA | MD | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revitalize Spine & Sports Care PLLC | Pain Medicine | Current | Accepting new patients |
| Prosser Public Hospital District of Benton County | Current | Accepting new patients | |
| Prosser Public Hospital District of Benton County | Current | Accepting new patients | |
| Prosser Public Hospital District of Benton County | Current | Accepting new patients |
Locations
1105 Dale Ave
Benton City, WA 99320
Phone (509) 588-4075
701 Dale Ave
Benton City, WA 99320
Phone (509) 588-4075
4309 W 27th Pl
Ste 202
Kennewick, WA 99338
Phone (509) 591-4966
200 Prosser Health Dr
Prosser, WA 99350
Phone (509) 786-2222
Interoperability endpoints
- jgroner1110221@wm.providencedirect.org
Organizations & group practices 4
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.
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Kennewick, WA
- NPI 1407430317
-
- Critical Access Hospital
- Prosser, WA
- NPI 1306897681
-
- Specialist
- Walla Walla, WA
- NPI 1518770155
-
- Multi-Specialty Clinic/Center
- Prosser, WA
- NPI 1821556408
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Richland, WA
- NPI 1972507580
-
- General Acute Care Hospital
- Walla Walla, WA
- NPI 1386895886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1184787491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4309 W 27TH PL STE 202",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993382908",
"telephone_number": "509-591-4966",
"fax_number": "509-396-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4309 W 27TH PL STE 202",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993382908",
"telephone_number": "509-591-4966",
"fax_number": "509-396-5033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRONER",
"first_name": "JOHN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "2081N0008X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
"state": "OR",
"license": "MD156621",
"primary": false
},
{
"code": "2081P2900X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pain Medicine",
"state": "OR",
"license": "MD156621",
"primary": false
},
{
"code": "2081P2900X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pain Medicine",
"state": "WA",
"license": "MD00049437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.