Jeremiah Grogg, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC009114 Issued in GA

Practice address

601 N Belair SQ Ste 2
Evans, GA 30809-0518

Phone

(706) 836-1195

Fax

(844) 873-4758

NPI assigned

Aug 11, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Spero Health of Virginia, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Martinsville, VA
  • NPI 1104465103
  Medicare reassignment NPD

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578017166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N BELAIR SQ STE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "706-836-1195",
            "fax_number": "844-873-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N BELAIR SQ STE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308090518",
            "telephone_number": "706-836-1195",
            "fax_number": "844-873-4758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Pleasant Home Rd",
            "address_2": "Suite G1",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309070518",
            "country_code": "US",
            "telephone_number": "706-364-4599",
            "fax_number": "706-364-4589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROGG",
        "first_name": "JEREMIAH",
        "name_prefix": "Mr.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181469A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Ann Gresham, APRN
• Thais Grice
• Carly Lambert Griffies, PA-C
• Brent Thomas Griffin, M.D.
• Kiara Griffin, RN BSN
• Morgan Groothand
• Grounded Paths Counseling and Wellness LLC
• Grow Pediatric Therapy and Group Services LLC
• Ashley Grubb
• Katie Guyton, PHARM.D.

• Professional Counselor in Evans, GA
• Providers in Evans, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.