Jeremy Michael Groll, MD

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

84514 Issued in OH

Practice address

7095 Clyo Rd
Centerville, OH 45459-4816

Phone

(937) 458-5084

Fax

(937) 458-5089

NPI assigned

Oct 31, 2005

Last updated

Aug 10, 2016By 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

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Innovative Fertility of Ohio, LLC

  dba SpringCreek Fertility

  • Reproductive Endocrinology Physician
  • Washington Township, OH
  • NPI 1558776245
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1356332357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7095 CLYO RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594816",
            "telephone_number": "937-458-5084",
            "fax_number": "937-458-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7095 CLYO RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594816",
            "telephone_number": "937-458-5084",
            "fax_number": "937-458-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROLL",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "OH",
            "license": "84514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Griffin
• Lorenda R Griffin, MSW, LISW
• Nicole Lynn Griffith
• Michelle Grim, M.ED., SP
• Jennifer Grimes
• Robert T Grossmann, MD
• Steven Michael Grout, O.D.
• Andrew Scott Gruner, PHARM D.
• Catarina D Gulledge, M.D.
• Carmen Michelle Gustafson, ANP

• Reproductive Endocrinology Physician in Centerville, OH
• Providers in Centerville, OH by specialty
• Reproductive Endocrinology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.