Peter Shelby Groce, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2014039715 Issued in MO

Practice address

3721 S Grand Blvd
Saint Louis, MO 63118-3405

Phone

(314) 328-0144

NPI assigned

Nov 19, 2014

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Dedicated Missouri Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Saint Louis, MO
  • NPI 1154968196
  NPD
• Dedicated Missouri Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Saint Louis, MO
  • NPI 1558909150
  NPD
• Dedicated Missouri Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Saint Louis, MO
  • NPI 1790317402
  NPD (past)
• Medical Care LLC

  • Health Service Clinic/Center
  • Florissant, MO
  • NPI 1609481696
  NPD (past)

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1245637271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "314-328-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183405",
            "telephone_number": "314-328-0144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3960 Lindell Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631083204",
            "country_code": "US",
            "telephone_number": "314-652-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5471 Dr Martin Luther King Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631124265",
            "country_code": "US",
            "telephone_number": "314-367-5820 x2221",
            "fax_number": "314-367-7010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROCE",
        "first_name": "PETER",
        "middle_name": "SHELBY",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-19",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2014039715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Dwyer Grither, RN,BC, ANP
• Whitney Rose Grither, MD
• Laura Elizabeth Grizzle
• Melissa Amy Grizzle, FNP
• Brian Groark
• Lisa Marie Grodeon
• Elizabeth F. Grodsky, PH.D.
• Russell John Louis Groener, MD
• Scott D Groesch, MD
• Elizabeth Michelle Grogan

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.