Jamie Lynn Bosma Groh, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

073353 Issued in GA

Practice address

111 Marble Mill Rd NW
Marietta, GA 30060-1047

Phone

(770) 422-1013

Fax

(770) 514-5996

NPI assigned

Nov 4, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marietta Dermatology Associates PAGroup PAC ID 6507850120, 22 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

76.61 of 100Reported as individual

Quality

58.56

Promoting interoperability

98

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Marietta Dermatology Associates PA

  • Dermatology Physician
  • Marietta, GA
  • NPI 1417007212
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1497082929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 NETTLE LN NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752651",
            "telephone_number": "561-329-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARBLE MILL RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601047",
            "telephone_number": "770-422-1013",
            "fax_number": "770-514-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROH",
        "first_name": "JAMIE",
        "middle_name": "LYNN BOSMA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-04",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "073353",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO 2158",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Cy Grinage, M.D.
• Joel A Gripshover, DC
• Jack Holland Grisham, PH.D.
• Darrell Grizzle, L.P.C.
• Nicholas Groene, RBT
• Karleigh Brooke Grondin
• Mark Daniel Gronsbell, M.D.
• Paul David Groover, NP-C
• Clara Elizabeth Gropman, MA, LPC
• Jennifer Bragg Gross, PT, DPT

• Dermatology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.