Active NPI
Michael James Grossell, DO
- Pediatrics Physician
- Shelby, NC
National Provider Identifier
1730167883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 9501262
- Practice address
- 305 W College Ave
Suite a
Shelby, NC 28152-8111 - Phone
- (704) 434-9686
- Fax
- (704) 434-9618
- NPI assigned
- Jan 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9501262 | NC | Primary |
Addresses
Primary practice location
305 W College Ave
Suite a
Shelby, NC 28152-8111
Mailing address
373 Dark Corner Rd
Rutherfordton, NC 28139-6757
Phone (704) 418-1210
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007P | Other | NC | BCBS IND |
| 891007P | Medicaid | NC |
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
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423440000000",
"number": "1730167883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "373 DARK CORNER RD",
"city": "RUTHERFORDTON",
"state": "NC",
"postal_code": "281396757",
"telephone_number": "704-418-1210",
"fax_number": "704-434-9618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 W COLLEGE AVE",
"address_2": "SUITE A",
"city": "SHELBY",
"state": "NC",
"postal_code": "281528111",
"telephone_number": "704-434-9686",
"fax_number": "704-434-9618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSELL",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-07",
"last_updated": "2015-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "9501262",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IND",
"identifier": "1007P",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891007P",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelby, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.