Individual provider Active NPI

Kathy Jean Groll

  • Homemaker
  • Sylvania, OH
National Provider Identifier
1295597532
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
Practice address
2424 Logwood CT
Sylvania, OH 43560-8960
Phone
(903) 570-0738
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X
HomemakerGroup: 193400000X SINGLE SPECIALTY GROUP 376J00000X Primary

Addresses

Primary practice location

2424 Logwood CT
Sylvania, OH 43560-8960

Mailing address

5541 Pawnee Rd
Toledo, OH 43613-1914
Phone (419) 508-4426

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1295597532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5541 PAWNEE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436131914",
            "telephone_number": "419-508-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 LOGWOOD CT",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435608960",
            "telephone_number": "903-570-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROLL",
        "first_name": "KATHY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.