NPIMap

Individual provider Active NPI

Marilyn L Phillips-Grossman, FNP

  • Nurse Practitioner
  • Danville, VA
National Provider Identifier
1649339367
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
007026D23 Issued in VA
Practice address
159 Executive Dr
Suite C
Danville, VA 24541-4160
Phone
(434) 792-0830
Fax
(434) 792-0468
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 007026D23 VA Primary

Addresses

Primary practice location

159 Executive Dr
Suite C
Danville, VA 24541-4160

Mailing address

159 Executive Dr
Suite C
Danville, VA 24541-4160
Phone (434) 792-0830

Other identifiers 1

IdentifierTypeStateIssuer
010108586MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031105000814 VA Practitioner - Nurse Practitioner 4183537277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danville Physician Practices LLCGroup PAC ID 4688606304, 171 clinicians
Professional Therapies of Roanoke, Inc.Group PAC ID 3375710619, 272 clinicians

Practice addresses (Care Compare)

142 S Main St
Danville, VA 24541-2922
Phone (434) 799-3866

159 Executive Dr
Danville, VA 24541-4160

165 Holt Garrison Pkwy
Danville, VA 24540-5949
Phone (434) 688-0163

188 S Main St
Danville, VA 24541-2922
Phone (434) 799-4592

Hospital & facility affiliations

  • Sovah Health Danville Hospital, Danville, VA, CCN 490075
  • Sentara Halifax Regional Hospital Hospital, South Boston, VA, CCN 490013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007026D23VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greensboro Pathology, LLC Current Accepting new patients
Danville Physician Practices LLC CurrentSince May 1, 2015 Accepting new patients
Danville Physician Practices LLC Nurse Practitioner CurrentSince May 1, 2015 Accepting new patients
Thompson Family Medical Center, PC Past Accepting new patients
Chatham Family Medical Center, Inc PastSince Sep 20, 2010 Accepting new patients

Locations

159 Executive Dr
Ste C
Danville, VA 24541
Phone (434) 792-0830

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

2232 Wilborn Ave
Ste F
South Boston, VA 24592
Phone (434) 517-8095

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIDIBD
  • Direct secure messaging: marilyn.phillips-grossman.1@19847.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1649339367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 EXECUTIVE DR",
            "address_2": "SUITE C",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414160",
            "telephone_number": "434-792-0830",
            "fax_number": "434-792-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 EXECUTIVE DR",
            "address_2": "SUITE C",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414160",
            "telephone_number": "434-792-0830",
            "fax_number": "434-792-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS-GROSSMAN",
        "first_name": "MARILYN",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "007026D23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010108586",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.