Individual provider Active NPI

Taylor Ann Rose Grueter, MHS, PA (ASCP)

  • Medical Laboratory Technician
  • Modesto, CA
National Provider Identifier
1902615503
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Laboratory TechnicianTaxonomy code 246RM2200X
Practice address
4301 N Star Way
Modesto, CA 95356-9262
Phone
(209) 577-1200
NPI assigned
Jan 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory Technician 246RM2200X Primary

Addresses

Primary practice location

4301 N Star Way
Modesto, CA 95356-9262

Mailing address

4301 N Star Way
Modesto, CA 95356-9262
Phone (209) 577-1200

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
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1902615503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 N STAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-577-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 N STAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-577-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUETER",
        "first_name": "TAYLOR ANN",
        "middle_name": "ROSE",
        "credential": "MHS, PA (ASCP)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

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