Active NPI
Kyle Robert Grooms, PHARMD
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1720976970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302417606
- Practice address
- 3610 Plainfield Ave NE
Grand Rapids, MI 49525-2402 - Phone
- (616) 365-1221
- Fax
- (616) 365-9996
- NPI assigned
- Jun 26, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302417606 | MI | Primary |
Addresses
Primary practice location
3610 Plainfield Ave NE
Grand Rapids, MI 49525-2402
Mailing address
7000 Camelback Dr NE
Rockford, MI 49341-9684
Phone (616) 884-0128
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302417606 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750896000000",
"number": "1720976970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7000 CAMELBACK DR NE",
"city": "ROCKFORD",
"state": "MI",
"postal_code": "493419684",
"telephone_number": "616-884-0128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3610 PLAINFIELD AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495252402",
"telephone_number": "616-365-1221",
"fax_number": "616-365-9996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROOMS",
"first_name": "KYLE",
"middle_name": "ROBERT",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-26",
"last_updated": "2025-06-26",
"certification_date": "2025-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302417606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.