Individual provider Active NPI

Andrea Grochowski

  • Speech-Language Pathologist
  • Bristol, VA
National Provider Identifier
1417415357
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202006924 Issued in VA
Practice address
245 North St
Bristol, VA 24201-3274
Phone
(276) 669-4711
NPI assigned
Mar 11, 2019
Last updated
Mar 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU
Speech-Language Pathologist 235Z00000X 2202006924 VA Primary

Addresses

Primary practice location

245 North St
Bristol, VA 24201-3274

Mailing address

245 North St
Bristol, VA 24201-3274

Other identifiers 2

IdentifierTypeStateIssuer
4779OtherTNTN SLP LICENSE
2202006924OtherVAVA SLP LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2202006924VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1417415357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 NORTH ST",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 NORTH ST",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013274",
            "telephone_number": "276-669-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROCHOWSKI",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN SLP LICENSE",
            "identifier": "4779",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA SLP LICENSE",
            "identifier": "2202006924",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.