Jeremy R Grover, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1625 Issued in CO

Practice address

2918 W 10TH St
Greeley, CO 80634-5457

Phone

(970) 584-2100

Fax

(970) 584-2101

NPI assigned

Sep 22, 2006

Last updated

Oct 30, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JG LLC

  dba Family Walk In Clinic

  • Primary Care Clinic/Center
  • Greeley, CO
  • NPI 1881101640
  NPD Authorized official
• Greeley Internal Medicine & Nephrology

  • Internal Medicine Physician
  • Greeley, CO
  • NPI 1548443039
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1285734038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345457",
            "telephone_number": "970-584-2100",
            "fax_number": "970-584-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345457",
            "telephone_number": "970-584-2100",
            "fax_number": "970-584-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "JEREMY",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISENCE NUMBER",
            "identifier": "1625",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "C462078",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Babette Grossman
• Mark D Grossnickle, MD
• Laura G Grotenhuis, MS ED
• Brittany Grounds, AGACNP - BC
• Alexander Thomas Grover, DO
• Cynthia L Gryboski, MD
• Emily Grzesiak
• Koy Rylee Gubler, DO
• Adrianna Guerra
• Jessica Marie Guerra

• Medical Physician Assistant in Greeley, CO
• Providers in Greeley, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.

Verify at the official NPI Registry.