Larry Jay Grong, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

39995 Issued in MN

Practice address

1282 Walnut St
Dawson, MN 56232

Phone

(320) 769-7393

Fax

(320) 769-2972

NPI assigned

Dec 11, 2006

Last updated

Mar 18, 2022By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

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.

• Appleton Area Health

  • Rural Health Clinic/Center
  • Appleton, MN
  • NPI 1730126673
  Medicare reassignment NPD
• Hendricks Community Hospital Assn & Retirement Home

  dba Hendricks Clinic

  • Rural Health Clinic/Center
  • Hendricks, MN
  • NPI 1013206812
  Medicare reassignment NPD
• Swift County-Benson Hospital

  • Critical Access Hospital
  • Benson, MN
  • NPI 1174529002
  Medicare reassignment NPD
• Appleton Area Health

  dba Appleton Area Health Services

  • Critical Access Hospital
  • Appleton, MN
  • NPI 1578590626
  NPD
• Hendricks Community Hospital Assn & Retirement Home

  dba Ivanhoe Medical Center

  • Rural Health Clinic/Center
  • Ivanhoe, MN
  • NPI 1952690034
  NPD
• Swift County Benson Hospital

  dba Swift County Benson Health Services

  • Family Medicine Physician
  • Benson, MN
  • NPI 1174077739
  NPD

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1871653758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1282 WALNUT ST",
            "city": "DAWSON",
            "state": "MN",
            "postal_code": "562322333",
            "telephone_number": "320-769-7393",
            "fax_number": "320-769-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 WALNUT ST",
            "city": "DAWSON",
            "state": "MN",
            "postal_code": "56232",
            "telephone_number": "320-769-7393",
            "fax_number": "320-769-2972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MN",
            "postal_code": "562561006",
            "country_code": "US",
            "telephone_number": "329-598-7551 x182",
            "fax_number": "320-598-3798",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MN",
            "postal_code": "562561006",
            "country_code": "US",
            "telephone_number": "329-598-7551 x182",
            "fax_number": "320-598-3798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRONG",
        "first_name": "LARRY",
        "middle_name": "JAY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "39995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4150236-00",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgrong@jmhs.securechart.com",
            "affiliation": "N",
            "address_1": "1282 Walnut St",
            "city": "Dawson",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dawson Drug PLLC
• Divine House II Inc.
• Krystle Marie Drietz, CNP, PMHNP
• Renae A Durfee, FNP-C
• Facing New Horizons, Inc.
• Thomas Walter Hansen, DDS
• Lindsey Anne Hanson, M.D., M.P.H
• Kase Allen Jacobs, CNP
• Johnson Memorial Health Services (Johnson Memorial Hospital)
• Johnson Memorial Health Services (Johnson Memorial Home Care)

• Internal Medicine Physician in Dawson, MN
• Providers in Dawson, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.