GRACE ELIZABETH GRONVOLD PA-C NPI 1821714106

NPI Information

NPI: 1821714106
Provider Name: GRACE ELIZABETH GRONVOLD, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
3009 NEW BERN AVE
RALEIGH, NC
ZIP 27610
Phone: (919) 232-5020
Get Directions

Grace Elizabeth Gronvold, PA-C is a surgical physician assistant in Raleigh, NC. Grace Elizabeth Gronvold, PA-C NPI is 1821714106. 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:

3009 NEW BERN AVE
RALEIGH, NC
ZIP 27610-214
Phone: (919) 232-5020

The NPI 1821714106 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 10/18/2022 and was last updated on 12/19/2022.

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	363A00000X	Physician Assistant		0010-12790	NORTH CAROLINA	No
2	363A00000X	Physician Assistant				No
3	363AM0700X	Physician Assistant	Medical			No
4	363AS0400X	Physician Assistant	Surgical			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	1821714106	MEDICAID	NORTH CAROLINA

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: 5/5/2024

NPI Synchronization or Removal

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