Active NPI
Mary Noel Grosskopf, FNP-C
- Primary Care Nurse Practitioner
- Gilbert, AZ
National Provider Identifier
1508151507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- AP4025
- Practice address
- 2915 E Baseline Rd
Suite 101
Gilbert, AZ 85234-2425 - Phone
- (480) 776-0626
- Fax
- (480) 776-0627
- NPI assigned
- Jun 17, 2011
- Last updated
- Jul 19, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | AP4025 | AZ | Primary |
Addresses
Primary practice location
2915 E Baseline Rd
Suite 101
Gilbert, AZ 85234-2425
Mailing address
1345 E Rockledge Rd
Phoenix, AZ 85048-6215
Phone (602) 403-1110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP4025 | Other | AZ | STATE NURSE PRACTIONER 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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP4025 | AZ | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aloha Cardiology P.C. | Past | Accepting new patients | |
| Innovative Primary Care LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Legal Medicine
- Gilbert, AZ
- NPI 1669437349
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1508151507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1345 E ROCKLEDGE RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850486215",
"telephone_number": "602-403-1110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2915 E BASELINE RD",
"address_2": "SUITE 101",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342425",
"telephone_number": "480-776-0626",
"fax_number": "480-776-0627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSKOPF",
"first_name": "MARY",
"middle_name": "NOEL",
"name_prefix": "Ms.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-17",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "AZ",
"license": "AP4025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE NURSE PRACTIONER LICENSE",
"identifier": "AP4025",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.