NPIMap

Individual provider Active NPI

Kenneth J Groh, PA-C

  • Physician Assistant
  • Towson, MD
National Provider Identifier
1730103342
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0000778 Issued in MD
Practice address
8322 Bellona Ave
Suite 100
Towson, MD 21204-2012
Phone
(410) 337-7900
Fax
(410) 337-5321
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0000778 MD Primary

Addresses

Primary practice location

8322 Bellona Ave
Suite 100
Towson, MD 21204-2012

Mailing address

8322 Bellona Ave
Suite 100
Towson, MD 21204-2012
Phone (410) 337-7900

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Orthopaedics, LLC Past Accepting new patients
Orthopaedic Associates, PA Past Accepting new patients

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1730103342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8322 BELLONA AVE",
            "address_2": "SUITE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042012",
            "telephone_number": "410-337-7900",
            "fax_number": "410-337-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8322 BELLONA AVE",
            "address_2": "SUITE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042012",
            "telephone_number": "410-337-7900",
            "fax_number": "410-337-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROH",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0000778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.