Individual provider Active NPI

Samantha A Grooss, MS, RD, LDN

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1861006405
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164007724 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(312) 227-4185
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD004973 GA
Registered Dietitian 133V00000X 164007724 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

505 N State St Apt 2108
Chicago, IL 60654-4813
Phone (630) 272-0622

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgrooss@luriechildrens.org

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
Master of Science

State licenses

LicenseStateTypeSpecialty
LD004973GAMDRegistered Dietitian
164007724ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1861006405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N STATE ST APT 2108",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544813",
            "telephone_number": "630-272-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOSS",
        "first_name": "SAMANTHA",
        "middle_name": "A",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD004973",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164007724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgrooss@luriechildrens.org",
            "affiliation": "Y",
            "endpointDescription": "email",
            "address_1": "225 E Chicago Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606112991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.