Meredith Elaine Grover, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD224450 Issued in OR

Practice address

4212 NE Broadway
Portland, OR 97213-1422

Phone

(503) 249-8787

NPI assigned

Apr 6, 2020

Sex

Female

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: meredith.grover.p1@direct.broadwaymedical.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Broadway Medical Clinic LLP

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1720082316
  Medicare reassignment NPD

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1205465705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 NE BROADWAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131422",
            "telephone_number": "503-249-8787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 NE 139th St # 400",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862301",
            "country_code": "US",
            "telephone_number": "360-577-1771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVER",
        "first_name": "MEREDITH",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD224450",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD.MD.61422980",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500862330",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_bmc_pediatrics_broadway_front_desk_pool12226302@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "4212 NE Broadway",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972131422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samuel Miles Grovenburg, M.D.
• Ellen R Grover, PT
• Kelly Grover, LPC
• Kelly Ruth Grover
• Marilyn C. Grover, LPC
• Morgan Grover
• Vikas Grover, MD
• Alison Rae Groves
• Aran Groves, MD
• Jasmine A Groves, QMHA-R

• Pediatrics Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.