Peggy Mary Grogan

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

12-12-010 Issued in FL

Practice address

1721 Timber Edge Dr
Deland, FL 32724-7985

Phone

(386) 589-6313

Fax

(386) 626-2675

NPI assigned

Feb 10, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1235883075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 TIMBER EDGE DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247985",
            "telephone_number": "386-589-6313",
            "fax_number": "386-626-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 TIMBER EDGE DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247985",
            "telephone_number": "386-589-6313",
            "fax_number": "386-626-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROGAN",
        "first_name": "PEGGY",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "12-12-010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles B Greenhouse
• Isabel Greiner, COTA/L
• Ann Marie Grell, LMHC
• Nicole Griffin
• Sue-Ellen Elizabeth Griffith, M.D.
• Guardian Home Healthcare LLC
• Luke Gerald Guillot, M.D.
• Haley Gunther
• Anika Gupta
• Anjali Gupta, MD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Deland, FL
• Providers in Deland, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.