Individual provider Active NPI

Amy Jo Grotewold, REGISTERED NURSE

  • Registered Nurse
  • Sioux Falls, SD
National Provider Identifier
1902611064
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
104809 Issued in IA
Practice address
2501 W 22ND St
Sioux Falls, SD 57105-1305
Phone
(605) 261-7545
NPI assigned
Feb 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1714065 MN
Registered Nurse 163W00000X 104809 IA Primary

Addresses

Primary practice location

2501 W 22ND St
Sioux Falls, SD 57105-1305

Mailing address

813 Churchill Dr
Larchwood, IA 51241-7751
Phone (605) 261-7545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104809IAMDRegistered Nurse
1714065MNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1738886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1902611064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 CHURCHILL DR",
            "city": "LARCHWOOD",
            "state": "IA",
            "postal_code": "512417751",
            "telephone_number": "605-261-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051305",
            "telephone_number": "605-261-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTEWOLD",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "1714065",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "104809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; 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.