Active NPI
Jill Marie Grotluschen, L.S.W
- Social Worker
- Fargo, ND
National Provider Identifier
1215296611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 4388
- Practice address
- 1112 Nodak Dr S
Suite 200
Fargo, ND 58103-2366 - Phone
- (701) 280-9545
- Fax
- (701) 280-9520
- NPI assigned
- May 7, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 4388 | ND | Primary |
Addresses
Primary practice location
1112 Nodak Dr S
Suite 200
Fargo, ND 58103-2366
Mailing address
1112 Nodak Dr S
Suite 200
Fargo, ND 58103-2366
Phone (701) 280-9545
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336348800000",
"number": "1215296611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 NODAK DR S",
"address_2": "SUITE 200",
"city": "FARGO",
"state": "ND",
"postal_code": "581032366",
"telephone_number": "701-280-9545",
"fax_number": "701-280-9520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 NODAK DR S",
"address_2": "SUITE 200",
"city": "FARGO",
"state": "ND",
"postal_code": "581032366",
"telephone_number": "701-280-9545",
"fax_number": "701-280-9520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROTLUSCHEN",
"first_name": "JILL",
"middle_name": "MARIE",
"credential": "L.S.W",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-07",
"last_updated": "2012-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ND",
"license": "4388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.