Andrew B Grose, DO
Family Medicine in Providence, UT. Individual provider (NPI-1).
NPI number1245895663
StatusActive
Last updated in NPPESSep 26, 2024
Details
- NPI
- 1245895663
- Entity type
- Individual (NPI-1)
- Name
- Andrew B Grose
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 1, 2019
- Certification date
- Sep 26, 2024
- Last updated
- Sep 26, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 12897926-1204 | UT | Yes |
Practice location
382 W 280 NProvidence, UT 84332-9118
Phone 435-752-0330 · Fax 435-755-0922
Mailing address
Po Box 5546Denver, CO 80217-5546
Phone 801-475-3500 · Fax 801-475-3414
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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