NPIMap

Individual provider Active NPI

Brien N Grow, DO

  • Anesthesiology Physician
  • Kokomo, IN
National Provider Identifier
1639199300
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
02001260A Issued in IN
Practice address
1907 W Sycamore St
Kokomo, IN 46901-5148
Phone
(765) 456-5433
NPI assigned
Jul 19, 2006
Last updated
May 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 02001260A IN Primary
Emergency Medicine Physician 207P00000X 02001260A IN

Addresses

Primary practice location

1907 W Sycamore St
Kokomo, IN 46901-5148

Mailing address

8840 Commerce Park PL Ste E
Indianapolis, IN 46268-3129

Other identifiers 4

IdentifierTypeStateIssuer
100366310MedicaidIN
100366310BMedicaidIN
200395990AMedicaidIN
000000728092OtherINANTHEM

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)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
02001260AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wabash Em I Medical Services PC Past Accepting new patients
Midwest Medical Management, P.C. Emergency Medicine Past Accepting new patients
Nufinity, LLC Past Accepting new patients
Mid State Logansport Ed Physicians Emergency Medicine Past Accepting new patients

Organizations & group practices 4

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1639199300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 COMMERCE PARK PL STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W SYCAMORE ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469015148",
            "telephone_number": "765-456-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROW",
        "first_name": "BRIEN",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "02001260A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02001260A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100366310",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100366310B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200395990A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000728092",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.