Kelly Renee Grogan, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN066578 Issued in AZ

Practice address

1910 E Thomas Rd Ste 200
Phoenix, AZ 85016-7767

Phone

(602) 266-2200

Fax

(602) 604-6134

NPI assigned

Dec 4, 2006

Last updated

Oct 21, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Mountain View Family Physicians

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1891990867
  Medicare reassignment NPD
• NM Pacs 2 LLC

  • Hospitalist Physician
  • Albuquerque, NM
  • NPI 1366928749
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1881752038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 E THOMAS RD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167767",
            "telephone_number": "602-266-2200",
            "fax_number": "602-604-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 E THOMAS RD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167767",
            "telephone_number": "602-266-2200",
            "fax_number": "602-604-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROGAN",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "name_prefix": "Miss",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN066578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Reed Groff, DPT
• Nicole Groff
• Patricia Groff, PHD
• Samantha Groft, AUD
• Brooke McGill Grogan, MD
• Scott William Grogan, M.D.
• Valarie C. Grogan, DO
• Brett Groh, PA-C
• Stacey J Grohall, CPNP
• Mahala Grohman, LPN

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.