MRS. MALLORY WILLIAMS GROSE (NPI# 1093089575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093089575 |
| Entity Type | Individual |
| Full Name | MRS. MALLORY WILLIAMS GROSE |
| Credential | ANP-C |
| Practice Address |
694 Riverside Dr Mount Airy NC 27030 |
| Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
| Practice Telephone | 3367197892 |
| Practice Fax Number | 3367197898 |
| Mailing Telephone | 3367197892 |
| Mailing Fax Number | 3367197898 |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2020-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5005508 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 905 Rockford St, Mount Airy, NC 270305323 | 3367192440 | 3367196915 |
| Street Address |
694 RIVERSIDE DR |
| City | MOUNT AIRY |
| State | NC |
| Zip Code | 27030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760483432 | Daniel L Schwartz | Physician Assistant | 694 Riverside Dr, Mount Airy, NC 27030-3117 | 2005-08-03 |
| 1184929796 | Nmg Affiliate Practice I LLC | Internal Medicine | 694 Riverside Dr, Mount Airy, NC 27030-3117 | 2011-01-13 |
| 1134339104 | Saeed Payvar | Internal Medicine | 694 Riverside Dr, Mount Airy, NC 27030-3117 | 2007-05-22 |
| 1659334530 | Nizar D Noureddine | Internal Medicine | 694 Riverside Dr, Mount Airy, NC 27030-3117 | 2006-04-10 |
| 1134191273 | Charles W. Harris Jr. | Internal Medicine | 694 Riverside Dr, Mount Airy, NC 27030-3117 | 2006-02-03 |
| 1043294200 | Bt Heart and Vascular Center, Pllc | Internal Medicine | 694 Riverside Dr, Mount Airy, NC 27030-3117 | 2005-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124475017 | Jeffrey Lynn Hunter | Podiatrist | 367 S Andy Griffith Pkwy # 200, Mount Airy, NC 27030 | 2016-05-20 |
| 1376984880 | Shari York | Counselor | 847 Westlake Dr, Mount Airy, NC 27030 | 2013-07-12 |
| 1861745069 | Surry-yadkin Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 1305 Park Dr, Mount Airy, NC 27030 | 2012-10-25 |
| 1346592169 | Debra Lynn Campbell | Physician Assistant | 709 West Independence Blvd., Mount Airy, NC 27030 | 2012-10-03 |
| 1720217680 | Lena Anderson Ferris | Nurse Practitioner | 708 S South St Ste 400, Mount Airy, NC 27030 | 2009-07-13 |
| 1013104520 | Tong Li-masters | Internal Medicine | 830 Rockford Street, Winston Salem, NC 27030 | 2007-09-28 |
| 1336261528 | Thomas R Jackson Dds Pa | Dentist | 1007 Rockford Street, Mount Airy, NC 27030 | 2007-04-06 |
| 1467585422 | Ridgecrest Ritirement Community | Assisted Living Facility | Ridgecrest Retirement, LLC, 1000 Ridgecrest Ln., Mount Airy, NC 27030 | 2007-03-13 |
| 1568516755 | Lou Urmos | Family Medicine | 805 Merita Street, Mt Airy, NC 27030 | 2007-01-23 |
| 1568516391 | Mark Lee Appler | Internal Medicine | 708 S South St Ste 100, Mount Airy, NC 27030 | 2007-01-22 |
| Find all providers in zip 27030 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083039192 | Suzanne Cerrone | Nurse Practitioner | 302 Watersville Rd, Ste 2, Mount Airy, MD 21771-5542 | 2014-02-26 |
| 1134451206 | Amy Puckett-lawson | Nurse Practitioner | 2133 Rockford St Ste 1400, Mount Airy, NC 27030-6594 | 2010-02-01 |
| 1720217680 | Lena Anderson Ferris | Nurse Practitioner | 708 S South St Ste 400, Mount Airy, NC 27030 | 2009-07-13 |
| 1861499691 | Elizabeth Ann Shockley | Nurse Practitioner | 401 Technology Ln Ste 200, Mount Airy, NC 27030-6692 | 2005-07-07 |
| 1174171631 | Victoria Lynn Mullins | Nurse Practitioner | 401 Technology Ln Ste 200, Mount Airy, NC 27030-5040 | 2019-08-28 |
| 1194386136 | Brittany Knicely Street | Nurse Practitioner | 280 N Pointe Blvd, Mount Airy, NC 27030 | 2019-06-20 |
| 1740844281 | Jessica Danyelle Darnell | Nurse Practitioner | 2133 Rockford St Ste 1400, Mount Airy, NC 27030-6594 | 2019-04-30 |
| 1164985008 | Amy Louise Crittenden | Nurse Practitioner | 401 Technology Ln, Mount Airy, NC 27030-5039 | 2019-04-08 |
| 1326514860 | Elizabeth Casstevens | Nurse Practitioner | 2133 Rockford St Ste 1400, Mount Airy, NC 27030-6594 | 2018-10-23 |
| 1770095416 | Jason Paul Cucchiara | Nurse Practitioner | 314 S South St, Mount Airy, NC 27030 | 2017-11-03 |
| Find all providers in MOUNT AIRY | ||||
| City | MOUNT AIRY |
| Zip Code | 27030 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.