Shaybriana Groth, PHARMD

Primary specialty

Pediatric PharmacistTaxonomy code 1835P0200X

License

051306418 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(414) 630-7572

NPI assigned

May 28, 2025

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1710770169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 W HAYMEADOW PL APT 2C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616153136",
            "telephone_number": "414-630-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "414-630-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTH",
        "first_name": "SHAYBRIANA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pediatrics",
            "state": "IL",
            "license": "051306418",
            "primary": true
        },
        {
            "code": "1835P0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pediatrics",
            "state": "WI",
            "license": "22474-40",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Thomas Gronset, DO
• Amanda Louise Gross, FNP
• Thomas Gross, M.D.
• Tyana Gross
• Michael Samuel Grossman, M.D.
• Leslie M Gruber, MOT,OTR/L
• Lindsey N Gruenwald, PA-C
• Aleshka Grusy, PTA
• Lindsey Lorraine Grys, APN
• Derek P Grzanich, DDS

• Pediatric Pharmacist in Peoria, IL
• Providers in Peoria, IL by specialty
• Pediatric Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.