Active NPI
Michael L Grome, PA-C
- Physician Assistant
- Hamlin, WV
National Provider Identifier
1598739807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 00285
- Practice address
- 7400 Lynn Ave
Hamlin, WV 25523-1138 - Phone
- (304) 824-5806
- Fax
- (304) 824-5885
- NPI assigned
- Feb 14, 2006
- Last updated
- Jun 5, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 00285 | WV | Primary |
Addresses
Primary practice location
7400 Lynn Ave
Hamlin, WV 25523-1138
Mailing address
7400 Lynn Ave
Hamlin, WV 25523-1138
Phone (304) 824-5806
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001719146 | Other | WV | MS BCBS |
| 080076470 | Other | WV | RR MC |
| 3810000508 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00285 | WV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physicians & Surgeons, Inc. | Current | Accepting new patients |
Locations
1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381
1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1598739807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 LYNN AVE",
"city": "HAMLIN",
"state": "WV",
"postal_code": "255231138",
"telephone_number": "304-824-5806",
"fax_number": "304-824-5885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 LYNN AVE",
"city": "HAMLIN",
"state": "WV",
"postal_code": "255231138",
"telephone_number": "304-824-5806",
"fax_number": "304-824-5885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROME",
"first_name": "MICHAEL",
"middle_name": "L",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "00285",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS BCBS",
"identifier": "001719146",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MC",
"identifier": "080076470",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810000508",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hamlin, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.