Active NPI
Raymond Grote, MD
- Pediatrics Physician
- Joplin, MO
National Provider Identifier
1770513210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R1C31
- Practice address
- 702 E 34TH Street
Ste 203
Joplin, MO 64804 - Phone
- (417) 523-4077
- Fax
- (417) 623-5171
- NPI assigned
- Jul 3, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R1C31 | MO | Primary |
Addresses
Primary practice location
702 E 34TH Street
Ste 203
Joplin, MO 64804
Mailing address
PO Box 3810
Joplin, MO 64803
Phone (417) 623-4077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11782 | Other | MO | ANTHEM |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1C31 | MO | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1770513210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3810",
"city": "JOPLIN",
"state": "MO",
"postal_code": "64803",
"telephone_number": "417-623-4077",
"fax_number": "417-623-5171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 E 34TH STREET",
"address_2": "STE 203",
"city": "JOPLIN",
"state": "MO",
"postal_code": "64804",
"telephone_number": "417-523-4077",
"fax_number": "417-623-5171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROTE",
"first_name": "RAYMOND",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R1C31",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "11782",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.