Susan L Groom, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

2000164251 Issued in MO

Practice address

RR 2 Box 46
Grant City, MO 64456-8948

Phone

(660) 326-2183

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1467650408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 46",
            "city": "GRANT CITY",
            "state": "MO",
            "postal_code": "644568948",
            "telephone_number": "660-326-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 46",
            "city": "GRANT CITY",
            "state": "MO",
            "postal_code": "644568948",
            "telephone_number": "660-326-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOM",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2000164251",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "2000164251",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Goff Management LLC Dba Orilla'S Way
• Stephen Ray Goff
• Laura Ann Mueller, MD
• Northwest Health Services Inc
• Northwest Medical Center Association, Inc
• Sherris Pharmacy Service
• Allison R. Thorn, FNP

• Pharmacist in Grant City, MO
• Providers in Grant City, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.