Individual provider Active NPI

Mary Clarke Grooms, MD

  • Pediatrics Physician
  • Gainesville, FL
National Provider Identifier
1568449254
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME84259 Issued in FL
Practice address
6440 W Newberry Rd
Ste 402
Gainesville, FL 32605-4381
Phone
(352) 332-5500
Fax
(352) 332-5506
NPI assigned
Dec 23, 2005
Last updated
Dec 9, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME84259 FL Primary
Pediatric Adolescent Medicine Physician 2080A0000X ME84259 FL

Addresses

Primary practice location

6440 W Newberry Rd
Ste 402
Gainesville, FL 32605-4381

Mailing address

6440 W Newberry Rd
Ste 402
Gainesville, FL 32605-4381
Phone (352) 333-5500

Other identifiers 1

IdentifierTypeStateIssuer
266131400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20090317000529 FL Practitioner - Pediatric Medicine 7214094358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Oct 12, 2010 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Oct 12, 2010 Accepting new patients
Gainesville Pediatric Associates Inc Pediatrics Past Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: mgrooms@gpai-fl.direct.office.nextgen.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1568449254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 W NEWBERRY RD",
            "address_2": "STE 402",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054381",
            "telephone_number": "352-333-5500",
            "fax_number": "352-333-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 W NEWBERRY RD",
            "address_2": "STE 402",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054381",
            "telephone_number": "352-332-5500",
            "fax_number": "352-332-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOMS",
        "first_name": "MARY",
        "middle_name": "CLARKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME84259",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME84259",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266131400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.