Melissa Grooms, MS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2811-266 Issued in WI

Practice address

36745 Aiken Road
Bayfield, WI 54814-4579

Phone

(715) 779-3707

Fax

(715) 779-3362

NPI assigned

Dec 10, 2015

Last updated

May 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Melissa L Jeffords Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Red Cliff Band of Lake Superior Chippewa Indians

  dba Red Cliff Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bayfield, WI
  • NPI 1497744015
  Medicare reassignment NPD
• Red Cliff Band of Lake Superior Chippewa Indians

  dba Red Cliff Ambulance Service

  • Land Ambulance
  • Bayfield, WI
  • NPI 1174672844
  NPD

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1710352109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36745 AIKEN ROAD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144579",
            "telephone_number": "715-779-3707",
            "fax_number": "715-779-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36745 AIKEN ROAD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144579",
            "telephone_number": "715-779-3707",
            "fax_number": "715-779-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOMS",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2811-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2811-266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "JEFFORDS",
            "middle_name": "L",
            "prefix": "MISS",
            "credential": "BA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph L Corbine, LPC, SAC, CSIT
• Mark Avery Fuller, MD
• Jacob P Geisler, MSW
• Martin A Gordon
• Isabel Georgiane Gregersen, LCSW
• Nicole Renee Gurnoe
• Grace M Heitsch, M.D.
• Ellie Heydari, DDS
• Allyssa Kimberly Hoopman
• Patricia M. Kenote-Deperry

• Professional Counselor in Bayfield, WI
• Providers in Bayfield, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.