Amy Louise Grube, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP10237 Issued in OH

Practice address

280 Pattonsville Rd
Jackson, OH 45640-9452

Phone

(740) 395-8677

Fax

(740) 395-8834

NPI assigned

Sep 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1992955314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-395-8677",
            "fax_number": "740-395-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 PATTONSVILLE RD",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456409452",
            "telephone_number": "740-395-8677",
            "fax_number": "740-395-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBE",
        "first_name": "AMY",
        "middle_name": "LOUISE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-22",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "10237",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP10237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAID CARESOURCE",
            "identifier": "310917085217",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00781887",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAID MOLINA",
            "identifier": "2878444",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2878444",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810016002",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAID UNISON",
            "identifier": "282601",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebekah S Greenlee, LSW
• Kimberly N. Gregg-Cornell, PT
• Hayden O Griffith
• Kimberly Grim, LSW
• David B Grimm, CRNA
• Allison Gutierrez, LPCC
• Kyle Hagen
• Chris Hager
• Faith Hale
• Jill Nicole Hallas

• Family Nurse Practitioner in Jackson, OH
• Providers in Jackson, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.