Jerrold Grodin, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G1023 Issued in TX

Practice address

621 N Hall St
Suite 400
Dallas, TX 75226-1339

Phone

(214) 826-5000

NPI assigned

Feb 14, 2006

Last updated

Jan 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1730153966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660080",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660080",
            "telephone_number": "214-237-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N HALL ST",
            "address_2": "SUITE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261339",
            "telephone_number": "214-826-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODIN",
        "first_name": "JERROLD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "G1023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael Grisham, LPC
• Zachary Brock Grisham
• Tyesha Grissom, PT, DPT
• Grit Chiropractic & Sports Medicine PLLC (Grit Sports Chiropractic)
• Austin Grob
• Justin Lee Grodin, MD
• Carla Groff, CRNA
• Travis Wesley Groff, CRNA
• David M Grogan, D.D.S., M.S.D.
• Stephanie Grogan, LPC, LCDC, NCC

• Cardiovascular Disease Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.