MRS. MICHELLE G GROTH NURSE PRACTITIONER NPI 1235158270

NPI Information

NPI: 1235158270
Provider Name: MRS. MICHELLE G GROTH, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: ST LUKES CLINIC-TREASURE VALLEY LLC

PECOS Registration: Yes

Address:
775 POLE LINE RD W
SUITE 315
TWIN FALLS, ID
ZIP 83301
Phone: (208) 814-8750
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MRS. Michelle G Groth, NURSE PRACTITIONER is an acute care nurse practitioner in Twin Falls, ID with 19 years of experience. MRS. Michelle G Groth, NURSE PRACTITIONER NPI is 1235158270. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

775 POLE LINE RD W
SUITE 315
TWIN FALLS, ID
ZIP 83301-814
Phone: (208) 814-8750

The NPI 1235158270 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 4/19/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		N-45468	IDAHO	No
2	363LA2100X	Nurse Practitioner	Acute Care	NP-1278A	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1257846	MEDICARE PIN	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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