Individual provider Active NPI

Tamra Leigh Groode, NP

  • Family Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1497996953
Registry record updated Mar 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18331 Issued in CA
Practice address
2701 Martin Luther King Jr Way
Berkeley, CA 94703-2165
Phone
(510) 644-6095
NPI assigned
Mar 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18331 CA Primary

Addresses

Primary practice location

2701 Martin Luther King Jr Way
Berkeley, CA 94703-2165

Mailing address

2701 Martin Luther King Jr Way
Berkeley, CA 94703
Phone (510) 644-6095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170210000455 CA Order and Referring Only - Nurse Practitioner 3678856911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1497996953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94703",
            "telephone_number": "510-644-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032165",
            "telephone_number": "510-644-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROODE",
        "first_name": "TAMRA",
        "middle_name": "LEIGH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-13",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.