Individual provider Active NPI

Sydney Grohler, FNP-C

  • Family Nurse Practitioner
  • Decatur, IL
National Provider Identifier
1336905736
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209028024 Issued in IL
Practice address
304 W Hay St Ste 213
Decatur, IL 62526-4169
Phone
(217) 876-6640
Fax
(217) 876-6645
NPI assigned
Feb 23, 2024
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209028024 IL Primary

Addresses

Primary practice location

304 W Hay St Ste 213
Decatur, IL 62526-4169

Mailing address

304 W Hay St Ste 213
Decatur, IL 62526-4169
Phone (217) 876-6640

Other identifiers 1

IdentifierTypeStateIssuer
309021634OtherILCS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716000880 IL Practitioner - Nurse Practitioner 4880139757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

Practice addresses (Care Compare)

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

241 W Weaver Rd
Suite 145B
Forsyth, IL 62535-9766
Phone (217) 876-5220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Memorial Hospital CurrentSince Jun 1, 2024 Accepting new patients
Decatur Memorial Hospital CurrentSince Jun 1, 2024 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

304 W Hay St
Ste 213
Decatur, IL 62526
Phone (217) 875-1518

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1336905736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W HAY ST STE 213",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264169",
            "telephone_number": "217-876-6640",
            "fax_number": "217-876-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W HAY ST STE 213",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264169",
            "telephone_number": "217-876-6640",
            "fax_number": "217-876-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROHLER",
        "first_name": "SYDNEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CS LICENSE",
            "identifier": "309021634",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.