Colleen Marie Grubb, CRNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

R139530 Issued in MD

Practice address

4940 Eastern Ave
Baltimore, MD 21224-2735

Phone

(410) 550-0395

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: cgrubb517791@direct.healthsystem.virginia.edu

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679622070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 SCHOOLERS POND WAY",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210121184",
            "telephone_number": "410-268-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBB",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MD",
            "license": "R139530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mari Louise Groves, M.D.
• Timothy Dana Groves Jr., PA-C
• Growing Hearts Pediatric Cardiology Inc
• Growing Roots Wellness
• David Robert Groy, D.M.D
• Katherine Grubb
• Lisa Myers Grubb
• Stephanie Grube, M.D.
• Donna Sue Gruber, RN, BSN
• Traci Grucz, PHARMD

• Neonatal Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Neonatal Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.