NPIMap

Individual provider Active NPI

Jeffrey Douglas Grow, M.D.

  • Family Medicine Physician
  • Fort Polk, LA
National Provider Identifier
1871572669
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101038571 Issued in VA
Practice address
1585 3Rd St
Fort Polk, LA 71459-5102
Phone
(207) 530-6514
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101038571 VA Primary

Addresses

Primary practice location

1585 3Rd St
Fort Polk, LA 71459-5102

Mailing address

1585 3Rd St
Fort Polk, LA 71459-5102
Phone (207) 530-6514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240329002208 MN Practitioner - Family Practice 1355371915 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians

Practice addresses (Care Compare)

1216 Ryans Rd
Worthington, MN 56187-1722
Phone (507) 372-2921

1216 Ryans Rd
Worthington, MN 56187-1781
Phone (507) 372-6522

Hospital & facility affiliations

  • Sanford Worthington Medical Center Hospital, Worthington, MN, CCN 240022
  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Current Accepting new patients
Rural Health Care, Inc. CurrentSince Aug 2, 2025 Accepting new patients
Avera McKennan Family Medicine CurrentSince Feb 17, 2024 Accepting new patients
Sanford Health Network Family Medicine Current Accepting new patients
Rural Health Care, Inc Family Medicine Current Accepting new patients
Sanford Health Network Current Accepting new patients
Rural Health Care, Inc CurrentSince Aug 2, 2025 Accepting new patients
Avera McKennan CurrentSince Feb 17, 2024 Accepting new patients
Rural Health Care, Inc. Past Accepting new patients
Avera McKennan Family Medicine Past Accepting new patients

Locations

1430 North Hwy
Jackson, MN 56143
Phone (507) 847-2200

300 S Bruce St
Ste 100
Marshall, MN 56258

1216 Ryans Rd
Ste 1
Worthington, MN 56187
Phone (507) 372-2921

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

1216 Ryans Rd
Worthington, MN 56187
Phone (507) 372-2921

Organizations & group practices 10

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

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1871572669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 3RD ST",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595102",
            "telephone_number": "207-530-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 3RD ST",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595102",
            "telephone_number": "207-530-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROW",
        "first_name": "JEFFREY",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101038571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Polk, LA

Sources for this page

Verify at the official NPI Registry.