Individual provider Active NPI

Nicole Grove, FNP-C

  • Family Nurse Practitioner
  • Moraine, OH
National Provider Identifier
1578973038
Registry record updated Jul 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA15850NP Issued in OH
Practice address
3421 Pinnacle Rd
Moraine, OH 45439-7918
Phone
(937) 268-3488
NPI assigned
May 5, 2014
Last updated
Jul 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA15850NP OH Primary

Addresses

Primary practice location

3421 Pinnacle Rd
Moraine, OH 45439-7918

Mailing address

901 E Central Ave Unit 49054
Dayton, OH 45449-7503
Phone (937) 573-7452

Other practice location 1

250 W Social Row Rd
Washington Township, OH 45458-4404
Phone (937) 573-7452

Other identifiers 1

IdentifierTypeStateIssuer
0102751MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140609000483 OH Practitioner - Nurse Practitioner 7810024122 Reassigns benefits to 1 organization
I20250814001070 FL Practitioner - Nurse Practitioner 7810024122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nicole Grove LLCGroup PAC ID 8224252572, 2 clinicians
Cardiac Vision LLCGroup PAC ID 9032349733, 66 clinicians

Practice addresses (Care Compare)

4830 Salem Ave
Dayton, OH 45416-1716
Phone (937) 573-7452

6817 Southpoint Pkwy
Suite 203
Jacksonville, FL 32216-6286
Phone (904) 231-1204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA15850NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Vision LLC CurrentSince Jul 8, 2025 Accepting new patients
Nicole Grove LLC CurrentSince Jan 30, 2014 Accepting new patients

Locations

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

4830 Salem Ave
Dayton, OH 45416
Phone (937) 278-2692

901 E Central Ave
Unit 49054
Dayton, OH 45449

119 W Somers St
Eaton, OH 45320
Phone (937) 456-3640

101 Mills Pl
New Lebanon, OH 45345
Phone (937) 603-4507

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Austin Trace Health and RehabilitationCenterville, OH, CCN 366466 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Aug 23, 2021
Aug 23, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752969600000",
    "number": "1578973038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E CENTRAL AVE UNIT 49054",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454497503",
            "telephone_number": "937-573-7452",
            "fax_number": "855-953-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 PINNACLE RD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454397918",
            "telephone_number": "937-268-3488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 W Social Row Rd",
            "address_purpose": "LOCATION",
            "city": "Washington Township",
            "state": "OH",
            "postal_code": "454584404",
            "country_code": "US",
            "telephone_number": "937-573-7452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVE",
        "first_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2025-07-20",
        "certification_date": "2025-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA15850NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102751",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.