DR. KYLE GROOM (NPI# 1063413656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063413656 |
| Entity Type | Individual |
| Full Name | DR. KYLE GROOM |
| Credential | D.O. |
| Practice Address |
1250 S Runnels St De Kalb TX 75559-2317 |
| Mailing Address |
216 N Centre St De Kalb TX 75559-1406 |
| Practice Telephone | 9036672273 |
| Practice Fax Number | 9036677597 |
| Mailing Telephone | 9036672273 |
| Mailing Fax Number | 9036677597 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2009-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | L5749 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | L5749 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1250 S RUNNELS ST |
| City | DE KALB |
| State | TX |
| Zip Code | 75559-2317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632619 | Ingram Health Consulting | Community/Behavioral Health | 1250 S Runnels St, De Kalb, TX 75559-2317 | 2020-05-30 |
| 1144585761 | Antonio Denard Ingram | Registered Nurse | 1250 S Runnels St, De Kalb, TX 75559-2317 | 2012-07-10 |
| 1174785687 | Janet Marlene Moreland | Physician Assistant | 1250 S Runnels St, De Kalb, TX 75559-2317 | 2008-06-26 |
| 1265565691 | Dekalb Physicians Clinic LLC | Family Medicine | 1250 S Runnels St, De Kalb, TX 75559-2317 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295138055 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 12522 Fm 1840, De Kalb, TX 75559 | 2014-10-07 |
| 1114079001 | Hubbard Independent School District | Local Education Agency (LEA) | 3347 Hwy 259 South, De Kalb, TX 75559 | 2007-01-18 |
| 1306871561 | Save Mart Pharmacy | Durable Medical Equipment & Medical Supplies | 136 N Centre, Dekalb, TX 75559 | 2006-07-12 |
| 1427052000 | Dekalb Pharmacy LLC | Pharmacy | 120 W Front St, De Kalb, TX 75559-1308 | 2005-06-10 |
| 1063474807 | Janet Tidwell | Pharmacist | 120 W Front St, De Kalb, TX 75559-1308 | 2006-04-05 |
| 1104904044 | David Blair Hodges | Dentist | 109 Oak St, De Kalb, TX 75559-1359 | 2006-11-01 |
| 1669537247 | Christy M. Walls | Pharmacist | 120 W Front St, De Kalb, TX 75559-1371 | 2006-12-26 |
| 1285770180 | John Franklin Cary | Pharmacist | 136 N Centre St, De Kalb, TX 75559-1404 | 2007-01-29 |
| 1902978364 | Total Medical Supply | Durable Medical Equipment & Medical Supplies | 216 N Centre St, De Kalb, TX 75559-1406 | 2006-11-14 |
| 1720416308 | Almer Lee Hadaway Jr. | Nurse Practitioner | 216 N Centre St, De Kalb, TX 75559-1406 | 2013-10-17 |
| Find all providers in zip 75559 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194020248 | Father of Waters Emergency Physicians LLC | Emergency Medicine | 14365 Highway 16 W, De Kalb, MS 39328-7974 | 2011-01-21 |
| 1417969031 | William Martin Bracken | Emergency Medicine | 14365 Highway 16 W, De Kalb, MS 39328-7974 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062297 | Davies Recovery,llc | Emergency Medicine | 9503 Middlex Dr, San Antonio, TX 78217-5915 | 2020-10-30 |
| 1841807526 | Talo Medical Management, LLC | Emergency Medicine | 4190 Fm 2933, Mckinney, TX 75071-0352 | 2020-09-28 |
| 1770199101 | Mavon Oversight Pllc | Emergency Medicine | 340 Van Bibber, Salado, TX 76571 | 2020-09-21 |
| 1568077675 | Eir Pllc | Emergency Medicine | 5150 Lemmon Ave Ste 108, Dallas, TX 75209-6428 | 2020-09-15 |
| 1942819479 | Atascocita Emergency Center, LLC | Emergency Medicine | 5324 Atascocita Rd Ste T, Humble, TX 77346-2971 | 2020-07-30 |
| 1467070698 | Emer Rowlett Physicians, Pllc | Emergency Medicine | 3301 Lakeview Pkwy, Rowlett, TX 75088-3321 | 2020-07-14 |
| 1225656176 | Summit Emergency Medicine Pllc | Emergency Medicine | 2501 W 7th St Ste 101, Fort Worth, TX 76107-8014 | 2020-07-08 |
| 1720604937 | Summit Emergency Medicine Pllc | Emergency Medicine | 606 Grapevine Hwy Ste Abc, Hurst, TX 76054-2758 | 2020-06-23 |
| 1669097382 | Star Ed Pllc | Emergency Medicine | 4617 Saint Clair Ct, Flower Mound, TX 75022-1041 | 2020-06-09 |
| 1992326078 | Sarah N Ibanez Shaw | Emergency Medicine | Ut Austin Dell Medical School Em Residency Program, 1400 N. I-35, Suite 2.230, Austin, TX 78701 | 2020-04-30 |
| Find all providers with the same taxonomy | ||||
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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.