Active NPI
Rodney Blaine Grover, DO
- Family Medicine Physician
- Fortuna, CA
National Provider Identifier
1790735223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A6001
- Practice address
- 3306 Renner Dr
Fortuna, CA 95540-3120 - Phone
- (707) 725-6101
- Fax
- (707) 725-2978
- NPI assigned
- May 12, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A6001 | CA | Primary |
Addresses
Primary practice location
3306 Renner Dr
Fortuna, CA 95540-3120
Mailing address
PO Box 1229
Weaverville, CA 96093-1229
Phone (530) 629-2363
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX60010 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A6001 | CA | MD | Family Medicine Physician |
| 6001 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790735223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1229",
"city": "WEAVERVILLE",
"state": "CA",
"postal_code": "960931229",
"telephone_number": "530-629-2363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3306 RENNER DR",
"city": "FORTUNA",
"state": "CA",
"postal_code": "955403120",
"telephone_number": "707-725-6101",
"fax_number": "707-725-2978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROVER",
"first_name": "RODNEY",
"middle_name": "BLAINE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A6001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX60010",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fortuna, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.