Individual provider Active NPI

Casey Grota, PHARM. D

  • Pharmacist
  • Conroe, TX
National Provider Identifier
1629351416
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2010034685 Issued in MO
Practice address
2117 Wood Duck Way
Conroe, TX 77384-2703
Phone
(157) 362-0609
NPI assigned
Sep 28, 2011
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2010034685 MO Primary

Addresses

Primary practice location

2117 Wood Duck Way
Conroe, TX 77384-2703

Mailing address

2117 Wood Duck Way
Conroe, TX 77384-2703
Phone (573) 620-6096

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
2010034685MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince May 3, 2020 Accepting new patients
Walgreen Co Past Accepting new patients

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": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1629351416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 WOOD DUCK WAY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773842703",
            "telephone_number": "573-620-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 WOOD DUCK WAY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773842703",
            "telephone_number": "157-362-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTA",
        "first_name": "CASEY",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2010034685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.