Daniel Groth
Individual provider Active NPI Contractor · Roanoke, VA
NPI 1376462200 · NPPES record last updated Jul 14, 2026
Key facts
- NPI
- 1376462200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 2705100660 (VA)
- Practice address
- 1114 Moorman Ave NW
Roanoke, VA 24017-5738 - Phone
- (540) 556-1178
- NPI assigned
- Jul 14, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor |
171W00000X | 2705100660 | VA | Yes |
Addresses
Primary practice location
1114 Moorman Ave NW
Roanoke, VA 24017-5738
Mailing address
1114 Moorman Ave NW
Roanoke, VA 24017-5738
Phone (540) 556-1178
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.