Individual provider Active NPI

Josie Gronbach

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1720515893
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
99095547B Issued in IN
Practice address
50 E 91St St Ste 316
Indianapolis, IN 46240-1556
Phone
(317) 550-3221
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 99095547B IN Primary

Addresses

Primary practice location

50 E 91St St Ste 316
Indianapolis, IN 46240-1556

Mailing address

50 E 91St St Ste 316
Indianapolis, IN 46240-1556
Phone (317) 550-3221

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL jgronbach@ipci.hush.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
99095547BINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maria P. Hanzlik, LLC Clinical PastSince Sep 27, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1720515893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E 91ST ST STE 316",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401556",
            "telephone_number": "317-550-3221",
            "fax_number": "317-550-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E 91ST ST STE 316",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401556",
            "telephone_number": "317-550-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONBACH",
        "first_name": "JOSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "99095547B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jgronbach@ipci.hush.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "50 E 91st St Ste 316",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462401556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.