Active NPI
Rose Y Grunert, FNP
- Family Nurse Practitioner
- Benton, IL
National Provider Identifier
1649378001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209005496
- Practice address
- 201 Bailey LN
Benton, IL 62812-1969 - Phone
- (618) 439-3161
- Fax
- (618) 439-7126
- NPI assigned
- Sep 20, 2006
- Last updated
- Mar 19, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209005496 | IL | Primary |
Addresses
Primary practice location
201 Bailey LN
Benton, IL 62812-1969
Mailing address
201 Bailey LN
Benton, IL 62812-1969
Phone (618) 439-3161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oza Oncology Inc. | Past | Accepting new patients | |
| Geriatric and Primary Care Services S C | Past | Accepting new patients |
Interoperability endpoints
- rgrunert@yourcarecommunity.org
- rosegrunert@franklinhhc.allscriptsdirect.net
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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- Mount Vernon, IL
- NPI 1053364885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552953600000",
"number": "1649378001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 BAILEY LN",
"city": "BENTON",
"state": "IL",
"postal_code": "628121969",
"telephone_number": "618-439-3161",
"fax_number": "618-439-7126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 BAILEY LN",
"city": "BENTON",
"state": "IL",
"postal_code": "628121969",
"telephone_number": "618-439-3161",
"fax_number": "618-439-7126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUNERT",
"first_name": "ROSE",
"middle_name": "Y",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2019-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209005496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.