Ted Groshong, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD31289 Issued in MO

Practice address

402 N Keene St
Ste 101
Columbia, MO 65201-6986

Phone

(573) 882-6921

Fax

(573) 882-1154

NPI assigned

May 22, 2006

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Curators of the University of Missouri

  • Community/Retail Pharmacy
  • Versailles, MO
  • NPI 1922032903
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1881649754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7687",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652057687",
            "telephone_number": "573-882-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N KEENE ST",
            "address_2": "STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016986",
            "telephone_number": "573-882-6921",
            "fax_number": "573-882-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSHONG",
        "first_name": "TED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "MD31289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS MEDICAID",
            "identifier": "140113001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD/BLUE CHOICE",
            "identifier": "3730",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "7509311",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "102486",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200528107",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS MEDICAID",
            "identifier": "2086349901",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott W Grisolano, M.D.
• Rachel Griswold
• Courtney Marie Groce, PLPC
• Kieth W Groh, MD
• Groovy Transportation LLC
• Kate Lauren Grossman, M.D.
• Erik Michael Grossmann, M.D.
• Christina Elizabeth Grotewiel, MS CCC SLP
• Breanna Christine Grotzinger, M.ED
• Christina Groves, RN

• Pediatrics Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.