Individual provider Active NPI

Danielle Nicole Grieb, APRN-CNP

  • Pediatrics Physician
  • Fremont, OH
National Provider Identifier
1396322905
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
423577 Issued in OH
Practice address
715 S Taft Ave
Fremont, OH 43420-3237
Phone
(419) 334-6679
NPI assigned
Mar 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 423577 OH Primary

Addresses

Primary practice location

715 S Taft Ave
Fremont, OH 43420-3237

Mailing address

295 Blue Harbor CT
Perrysburg, OH 43551-2842
Phone (419) 704-7269

Other practice location 1

295 Blue Harbor Ct
Perrysburg, OH 43551-2842
Phone (419) 704-7269

Other identifiers 1

IdentifierTypeStateIssuer
0463416MedicaidOH

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211119002426 OH Practitioner - Nurse Practitioner 8628467297 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
423577OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Mar 1, 2023 Accepting new patients
Promedica Central Physicians CurrentSince Mar 1, 2023 Accepting new patients

Locations

715 S Taft Ave
Ste 3C
Fremont, OH 43420

715 S Taft Ave
Fremont, OH 43420
Phone (419) 332-7321

217 Golden Gate Plz
Maumee, OH 43537
Phone (567) 585-0210

2751 Bay Park Dr
Ste 202
Oregon, OH 43616
Phone (419) 690-7550

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1396322905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 BLUE HARBOR CT",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512842",
            "telephone_number": "419-704-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S TAFT AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203237",
            "telephone_number": "419-334-6679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Blue Harbor Ct",
            "address_purpose": "LOCATION",
            "city": "Perrysburg",
            "state": "OH",
            "postal_code": "435512842",
            "country_code": "US",
            "telephone_number": "419-704-7269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIEB",
        "first_name": "DANIELLE",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-28",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "423577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463416",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

Verify at the official NPI Registry.