Individual provider Active NPI

Debra Ruth Gromley, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • Decatur, IL
National Provider Identifier
1992920516
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
209000998 Issued in IL
Practice address
2220 N Monroe St
Suite 1
Decatur, IL 62526-6304
Phone
(217) 875-1886
Fax
(217) 875-3120
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209000998 IL Primary

Addresses

Primary practice location

2220 N Monroe St
Suite 1
Decatur, IL 62526-6304

Mailing address

504 W Jackson St
Sullivan, IL 61951-1360
Phone (217) 728-4943

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

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992920516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W JACKSON ST",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619511360",
            "telephone_number": "217-728-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 N MONROE ST",
            "address_2": "SUITE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266304",
            "telephone_number": "217-875-1886",
            "fax_number": "217-875-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROMLEY",
        "first_name": "DEBRA",
        "middle_name": "RUTH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209000998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.