Kevin L Grooms, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1076162 Issued in AL

Practice address

5947 Highway 269
Parrish, AL 35580

Phone

(205) 686-5113

Fax

(205) 686-5145

NPI assigned

Jun 17, 2011

Last updated

Dec 7, 2015By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: kevin.grooms.1@15479.direct.athenahealth.com

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1841585841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5947 HIGHWAY 269",
            "city": "PARRISH",
            "state": "AL",
            "postal_code": "35580",
            "telephone_number": "205-686-5113",
            "fax_number": "205-686-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5947 HIGHWAY 269",
            "city": "PARRISH",
            "state": "AL",
            "postal_code": "35580",
            "telephone_number": "205-686-5113",
            "fax_number": "205-686-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOMS",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1076162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ALABAMA",
            "identifier": "511-55403",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167059",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Parrish, AL
• Providers in Parrish, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.

Verify at the official NPI Registry.