Active NPI
Patricia Ann Groessl, EDD
- Clinical Psychologist
- Muskegon, MI
National Provider Identifier
1396811048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 005960
- Practice address
- 1148 Fourth St
Muskegon, MI 49441 - Phone
- (231) 726-2299
- Fax
- (231) 728-6345
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 005960 | MI | Primary |
Addresses
Primary practice location
1148 Fourth St
Muskegon, MI 49441
Mailing address
1148 Fourth St
Muskegon, MI 49441
Phone (231) 726-2299
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680F148860 | Other | MI | BCBS |
| 041831 | Other | MI | OPTIONS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005960 | MI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1396811048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1148 FOURTH ST",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "49441",
"telephone_number": "231-726-2299",
"fax_number": "231-728-6345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1148 FOURTH ST",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "49441",
"telephone_number": "231-726-2299",
"fax_number": "231-728-6345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROESSL",
"first_name": "PATRICIA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "EDD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "005960",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "680F148860",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIONS",
"identifier": "041831",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.