Marilyn S Groves, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71001259A Issued in IN

Practice address

2600 Oakland Ave
Elkhart, IN 46517-1533

Phone

(574) 533-1234

Fax

(574) 537-2652

NPI assigned

Jun 15, 2006

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

Other identifiers 3

Other names 1

• Marilyn S Rogers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1710921267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LAKEVIEW DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465289365",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OAKLAND AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465171533",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVES",
        "first_name": "MARILYN",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71001259A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00106755",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000533123",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200361200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "ROGERS",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Preeya Patel Grewal, MD
• Kelly Griffin, MS
• Mackenzie Linn Griman, PA-C
• Krista Diane Gritzmaker, MA, BCBA
• Gene W Grove, MD
• Anne K. Gruber, PA-C
• Ruth Lapp Guengerich
• Kerry M Guernsey
• Alexis Gullett
• Anjana Gupta, D.D.S.

• Pediatric Nurse Practitioner in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.