Individual provider Active NPI

Nicole Grove, APRN

  • Family Nurse Practitioner
  • Windham, NH
National Provider Identifier
1902401557
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011293 Issued in FL
Practice address
22 Roulston Rd
Windham, NH 03087-1209
Phone
(603) 898-6492
NPI assigned
Dec 2, 2020
Last updated
Mar 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11011293 FL Primary
Emergency Registered Nurse 163WE0003X RN9231690 FL

Addresses

Primary practice location

22 Roulston Rd
Windham, NH 03087-1209

Mailing address

1698 W Hibiscus Blvd Ste B
Melbourne, FL 32901-2639
Phone (321) 676-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20210408002011 FL Practitioner - Nurse Practitioner 3870901978 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

105 S Banana River Blvd
Cocoa Beach, FL 32931-5041
Phone (407) 200-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9231690FLMDEmergency Registered Nurse
APRN11011293FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System Sunbelt, Inc. Family Current Accepting new patients
Urgent Care Centers of Brevard County LLC Family Current Accepting new patients
Adventist Health System/ Sunbelt, Inc. Family CurrentSince Jan 14, 2022 Accepting new patients
Adventist Health System/Sunbelt, Inc. Family CurrentSince Jan 14, 2022 Accepting new patients
Urgent Care Centers of Brevard County LLC Family CurrentSince Jan 14, 2022 Accepting new patients
Urgent Care Centers of Brevard County LLC Family CurrentSince Jan 14, 2022 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

105 S Banana River Blvd
Cocoa Beach, FL 32931
Phone (321) 783-3362

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ngrove222949@adventhealth.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1902401557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 W HIBISCUS BLVD STE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012639",
            "telephone_number": "321-676-3200",
            "fax_number": "321-802-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ROULSTON RD",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030871209",
            "telephone_number": "603-898-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVE",
        "first_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011293",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "RN9231690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windham, NH

Sources for this page

Verify at the official NPI Registry.