Individual provider Active NPI

Robert Kim Grossman

  • Adult Health Nurse Practitioner
  • Danville, VA
National Provider Identifier
1639302789
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024168401 Issued in VA
Practice address
159 Executive Dr
Suite F
Danville, VA 24541-4160
Phone
(434) 792-4378
Fax
(434) 799-0860
NPI assigned
Aug 24, 2009
Last updated
Nov 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024168401 VA Primary
Adult Health Clinical Nurse Specialist 364SA2200X 0024168401 VA

Addresses

Primary practice location

159 Executive Dr
Suite F
Danville, VA 24541-4160

Mailing address

159 Executive Drive
Suite F
Danville, VA 24541-4160
Phone (434) 792-4378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20091102000096 VA Practitioner - Nurse Practitioner 8123057650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Danville Physician Practices LLCGroup PAC ID 4688606304, 171 clinicians

Practice addresses (Care Compare)

159 Executive Dr
Suite F
Danville, VA 24541-4160
Phone (434) 792-4378

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Danville Physician Practices LLC CurrentSince Jun 1, 2015 Accepting new patients
Danville Physician Practices LLC CurrentSince Jun 1, 2015 Accepting new patients
Greensboro Pathology, LLC Current Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

159 Executive Dr
Ste F
Danville, VA 24541
Phone (434) 792-4378

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4
  • Direct secure messaging: robert.grossman.1@19847.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1639302789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 EXECUTIVE DRIVE",
            "address_2": "SUITE F",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414160",
            "telephone_number": "434-792-4378",
            "fax_number": "434-799-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 EXECUTIVE DR",
            "address_2": "SUITE F",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414160",
            "telephone_number": "434-792-4378",
            "fax_number": "434-799-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "ROBERT",
        "middle_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-24",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024168401",
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "VA",
            "license": "0024168401",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.