Tedd D Groshong, DO

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

D00012 Issued in GU

Practice address

850 Governor Carlos Camacho Road
Oka Tamuning, GU 96913-3128

Phone

(671) 647-2418

Fax

(671) 649-5508

NPI assigned

Jan 3, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Hawaii Community Health Center, Inc.

  dba Hawaii Island Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pahoa, HI
  • NPI 1861376907
  NPD (past)
• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kailua Kona, HI
  • NPI 1952335630
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831246065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 GOVERNOR CARLOS CAMACHO ROAD",
            "city": "OKA TAMUNING",
            "state": "GU",
            "postal_code": "969133128",
            "telephone_number": "671-647-2418",
            "fax_number": "671-649-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 GOVERNOR CARLOS CAMACHO ROAD",
            "city": "OKA TAMUNING",
            "state": "GU",
            "postal_code": "969133128",
            "telephone_number": "671-647-2418",
            "fax_number": "671-649-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSHONG",
        "first_name": "TEDD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "GU",
            "license": "D00012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "0000LCBST",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alix J Chenet, MD
• John H Garrido, MD
• Guam Memorial Hospital
• Guam Memorial Hospital
• Guam Memorial Hospital
• Aaron C Johansen, MD
• Robert J Kwok, MD

• Emergency Medical Services (Emergency Medicine) Physician in Oka Tamuning, GU
• Providers in Oka Tamuning, GU by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.