Emma Jane Groethe, CNP, MSN
Individual provider Active NPI Family Nurse Practitioner · Northfield, OH
NPI 1376628636 · NPPES record last updated Dec 14, 2020
Key facts
- NPI
- 1376628636
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 09173 (OH)
- Practice address
- 9302 Olde 8 Rd
Northfield, OH 44067-2027 - Phone
- (330) 468-1661
- Fax
- (330) 908-1145
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240805003943 | OH | Practitioner - Nurse Practitioner | 8123932225 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09173 | OH | MD | Family Nurse Practitioner |
| 133665 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health, LLC | Current |
Accepting new patients | |
| Comprehensive Medical Services LLC | Past | Accepting new patients |
Locations
175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 133665 | OH | |
| Family Nurse Practitioner | 363LF0000X | 09173 | OH | Yes |
Addresses
Primary practice location
9302 Olde 8 Rd
Northfield, OH 44067-2027
Mailing address
485 Carlsfield Way
Hudson, OH 44236-1173
Phone (216) 288-4004
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01249 | Other | OH | CNS OHIO COA |
| 2006007685-21 | Other | NP CERTIFICATION | |
| 2594296 | Medicaid | OH | |
| NP-09173 | Other | OH | CERTIFICED NURSE PRACTITI |
Other providers in Northfield, OH
- Zev I Goldberg
- Kathy Ritter Gonzalez
- Quawuna Good
- Zinovi Goubar
- Wendy K Griffiths
- Angela Gromovsky
- Rokibul R Hasan
- Krystal Elaine Hawks
- Amanda Hetrick
- Theresa Marie Hibbard
All providers in Northfield, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.