Active NPI
Katrina Carol Groves-Rehwaldt, MD
- Addiction Medicine (Family Medicine) Physician
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- License
- G69202
- Practice address
- 2960 Camino Diablo Ste 105
Walnut Creek, CA 94597-3945 - Phone
- (800) 892-2695
- NPI assigned
- Oct 2, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | MD19537 | OR | |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | G69202 | CA | Primary |
Addresses
Primary practice location
2960 Camino Diablo Ste 105
Walnut Creek, CA 94597-3945
Mailing address
2960 Camino Diablo Ste 105
Walnut Creek, CA 94597-3945
Phone (800) 892-2695
Other names 1
- Katrina Carol Groves
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G69202 | CA | MD | Addiction Medicine (Family Medicine) Physician |
| MD19537 | OR | MD | Addiction Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open Door Community Health Centers | Current | Accepting new patients | |
| Open Door Community Health Centers | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients |
Locations
1275 8th St
Arcata, CA 95521
550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636
1515 Village Dr
Cottage Grove, OR 97424
Phone (541) 767-5200
1515 Village Dr
Ste 200
Cottage Grove, OR 97424
Phone (541) 767-5200
1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253
Interoperability endpoints
- kgrovesrehwaldt367931@direct.peacehealth.org
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Crescent City, CA
- NPI 1497840656
-
- Critical Access Hospital
- Cottage Grove, OR
- NPI 1902892391
-
- Federally Qualified Health Center (FQHC)
- Eureka, CA
- NPI 1831713452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1487748943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2960 CAMINO DIABLO STE 105",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945973945",
"telephone_number": "800-892-2695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 CAMINO DIABLO STE 105",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945973945",
"telephone_number": "800-892-2695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROVES-REHWALDT",
"first_name": "KATRINA",
"middle_name": "CAROL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "OR",
"license": "MD19537",
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "CA",
"license": "G69202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATRINA",
"last_name": "GROVES",
"middle_name": "CAROL",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.