Individual provider Active NPI

Susan M Grove, FNP

  • Family Nurse Practitioner
  • Rome, NY
National Provider Identifier
1992702666
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F331849 Issued in NY
Practice address
91 Perimeter Rd
Suite 120
Rome, NY 13441-4018
Phone
(315) 336-8260
Fax
(315) 337-3807
NPI assigned
Jul 7, 2005
Last updated
May 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F331849 NY Primary

Addresses

Primary practice location

91 Perimeter Rd
Suite 120
Rome, NY 13441-4018

Mailing address

91 Perimeter Rd
Suite 120
Rome, NY 13441-4018
Phone (315) 336-8260

Other identifiers 1

IdentifierTypeStateIssuer
02195260MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F331849NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1992702666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 PERIMETER RD",
            "address_2": "SUITE 120",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134414018",
            "telephone_number": "315-336-8260",
            "fax_number": "315-337-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 PERIMETER RD",
            "address_2": "SUITE 120",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134414018",
            "telephone_number": "315-336-8260",
            "fax_number": "315-337-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVE",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02195260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.