Active NPI
Molly Elliott Meadows Grundy, ACCNS
- Critical Care Medicine Clinical Nurse Specialist
- Lafayette, IN
National Provider Identifier
1538795604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Clinical Nurse Specialist
- License
- 28187462A
- Practice address
- 1701 S Creasy LN
Lafayette, IN 47905-4972 - Phone
- (765) 428-3448
- NPI assigned
- Mar 20, 2020
- 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 |
|---|---|---|---|---|
| Critical Care Medicine Clinical Nurse Specialist | 364SC0200X | 28187462A | IN | Primary |
Addresses
Primary practice location
1701 S Creasy LN
Lafayette, IN 47905-4972
Mailing address
600 W Main St
Crawfordsville, IN 47933-1626
Phone (765) 918-1154
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28187462A | IN | MD | Critical Care Medicine Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584662400000",
"number": "1538795604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 W MAIN ST",
"city": "CRAWFORDSVILLE",
"state": "IN",
"postal_code": "479331626",
"telephone_number": "765-918-1154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 S CREASY LN",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054972",
"telephone_number": "765-428-3448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUNDY",
"first_name": "MOLLY",
"middle_name": "ELLIOTT MEADOWS",
"credential": "ACCNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-20",
"last_updated": "2020-03-20",
"certification_date": "2020-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "364SC0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Critical Care Medicine",
"state": "IN",
"license": "28187462A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.