Active NPI
Elizabeth A Grose, ARNP
- Nurse Practitioner
- Yakima, WA
National Provider Identifier
1508937004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP30006768
- Practice address
- 717 Fruitvale Blvd
Yakima, WA 98902-1465 - Phone
- (509) 966-0199
- Fax
- (509) 966-4266
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30006768 | WA | Primary |
Addresses
Primary practice location
717 Fruitvale Blvd
Yakima, WA 98902-1465
Mailing address
717 Fruitvale Blvd
Yakima, WA 98902-1465
Phone (509) 966-0199
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8943771 | Other | WA | CRIME VICTIMS |
| 9066GR | Other | WA | REGENCE |
| 0194525 | Other | WA | LABOR AND INDUSTRIES |
| 9645060 | Medicaid | WA |
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 |
|---|---|---|---|
| AP30006768 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Washington University Student Health Counseling and Wellness | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Health Service Clinic/Center
- Ellensburg, WA
- NPI 1548460025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1508937004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 FRUITVALE BLVD",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989021465",
"telephone_number": "509-966-0199",
"fax_number": "509-966-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 FRUITVALE BLVD",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989021465",
"telephone_number": "509-966-0199",
"fax_number": "509-966-4266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSE",
"first_name": "ELIZABETH",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP30006768",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8943771",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "9066GR",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0194525",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9645060",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.