Individual provider Active NPI

Erica Rene Gruhala

  • Speech-Language Pathologist
  • Bonne Terre, MO
National Provider Identifier
1770741357
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2015010239 Issued in MO
Practice address
405 Hillcrest St
Bonne Terre, MO 63628-1421
Phone
(573) 431-3300
NPI assigned
May 29, 2008
Last updated
May 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2015010239 MO Primary

Addresses

Primary practice location

405 Hillcrest St
Bonne Terre, MO 63628-1421

Mailing address

712 Warren St
Farmington, MO 63640-2621
Phone (573) 631-2113

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

State licenses

LicenseStateTypeSpecialty
2015010239MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1770741357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 WARREN ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402621",
            "telephone_number": "573-631-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 HILLCREST ST",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636281421",
            "telephone_number": "573-431-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUHALA",
        "first_name": "ERICA",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2015010239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonne Terre, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.