Jeffrey S Groothuis, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

01045118A Issued in IN

Practice address

2030 W Boulevard
Kokomo, IN 46902-6079

Phone

(765) 454-0200

NPI assigned

Feb 24, 2006

Last updated

Sep 22, 2022By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jeffrey.groothuis.1@7598.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Care Group LLC

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1649220195
  NPD (past)
• Ekg Interpretation Professionsals

  • Cardiovascular Disease Physician
  • Kokomo, IN
  • NPI 1912009119
  NPD (past)
• The Care Labs, LLC

  • Vascular & Interventional Radiology Physician
  • Indianapolis, IN
  • NPI 1215978523
  NPD (past)

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1255307880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026079",
            "telephone_number": "765-454-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOTHUIS",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01045118A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200100090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marley A Griffin Fagg, DO
• Bradley James Griggs
• Brooklyn Grimes
• Christina R Grimm, NP
• Inna Grishin, DDS
• Olivia Gross
• Teresa Lynne Gross, PTA
• Maeghan Grove, ACIT 1
• Brien N Grow, DO
• Mary Grubb, MSW, LCSW

• Cardiovascular Disease Physician in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Cardiovascular Disease Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.