MR. CALEB W GROVE (NPI# 1700973583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700973583 |
| Entity Type | Individual |
| Full Name | MR. CALEB W GROVE |
| Credential | P.A. |
| Practice Address |
700 W Central Ave Ste 105 El Dorado KS 67042-2187 |
| Mailing Address |
720 W Central Ave El Dorado KS 67042-2112 |
| Practice Telephone | 3163229813 |
| Practice Fax Number | 3163229806 |
| Mailing Telephone | 3163222490 |
| Mailing Fax Number | 3163212916 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
T00782 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
15-01144 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BLUE CROSS BLUE SHIELD | 0000427308 | 01 |
| KS | 200406070D | 05 |
| Street Address |
700 W CENTRAL AVE STE 105 |
| City | EL DORADO |
| State | KS |
| Zip Code | 67042-2187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629003223 | Gerard Fernandez Librodo | Orthopaedic Surgery | 700 W Central Ave Ste 105, El Dorado, KS 67042-2187 | 2006-07-11 |
| 1194247007 | Susan B. Allen Memorial Hospital | Orthopaedic Surgery | 700 W Central Ave Ste 105, El Dorado, KS 67042-2187 | 2017-07-12 |
| 1841687464 | Nicholas J Posge | Podiatrist | 700 W Central Ave Ste 105, El Dorado, KS 67042 | 2015-04-21 |
| 1548468648 | Susan B. Allen Memorial Hospital | Orthopaedic Surgery | 700 W Central Ave Ste 105, El Dorado, KS 67042-2187 | 2007-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821526104 | Nolan Ryan Andrews | Dentist | 535 S. Main Street, El Dorado, KS 67042 | 2017-05-31 |
| 1902262355 | Lisbeth Leiber | Nurse Practitioner | 1737 Se Hwy 54, El Dorado, KS 67042 | 2016-01-14 |
| 1992180202 | Jennifer Clausing | Pharmacist | 205 N. Vine, El Dorado, KS 67042 | 2015-07-28 |
| 1053706655 | Aubrey Shea Ralston | General Practice | 700 W Central Ave Ste 205, El Dorado, KS 67042 | 2015-03-31 |
| 1316341027 | William L Wade | Nurse Practitioner | 1737 Se Highway 54, Eldorado, KS 67042 | 2014-10-09 |
| 1205070612 | Gabriel Omar De La Garza | Otolaryngology | 700 W Central Ave Suite 200, Eldorado, KS 67042 | 2009-04-29 |
| 1962608893 | South Central Mental Health Counseling Center Inc | Social Worker | 120 S Gordy, 3, El Dorado, KS 67042 | 2007-06-26 |
| 1699987958 | Grene Vision Group LLC | Ophthalmology | 1400 W Central, El Dorado, KS 67042 | 2007-05-07 |
| 1548388598 | Richard Alan Burton | Dentist | 310 Oil Hill Road, El Dorado, KS 67042 | 2007-03-27 |
| 1710002472 | Tender Care Pediatrics Pa | Pediatrics | 700 W. Central Ave, Ste 210, El Dorado, KS 67042 | 2007-03-20 |
| Find all providers in zip 67042 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205386604 | Tessa M Lee | Physician Assistant | 600 S Timberlane Dr, El Dorado, AR 71730-6990 | 2016-10-10 |
| 1902273931 | Matthew Lee Aitchison | Physician Assistant | 700 W Central Ave, Suite #205, El Dorado, KS 67042-2184 | 2015-08-25 |
| 1285816363 | El Dorado Emergency Group LLC | Physician Assistant | 700 W Grove St, El Dorado, AR 71730-4416 | 2007-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487277703 | Riann Paige Tyree | Physician Assistant | 724 W Lincoln Ave, Greensburg, KS 67054-2522 | 2020-05-20 |
| 1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
| 1912408717 | Alyssa Ann Farrell | Physician Assistant | 235 W Vine St., Dighton, KS 67839 | 2018-02-27 |
| 1740790500 | Tory Christopher Fisher | Physician Assistant | 22450 S Harrison St Ste 100, Spring Hill, KS 66083-8882 | 2017-10-06 |
| 1619407871 | Lisa Raylene Steers | Physician Assistant | Po Box 10, Hugoton, KS 67951-0010 | 2017-06-19 |
| 1922547371 | Anna Ruelberg | Physician Assistant | 4921 W 18th Street, Lawrence, KS 66047-2090 | 2017-02-17 |
| 1255888319 | Morgan J Martin | Physician Assistant | 2610 N Woodlawn, Wichita, KS 67220 | 2016-09-07 |
| 1598135808 | Tracy Hoelting | Physician Assistant | 1150 N 75th Pl Ste 200, Kansas City, KS 66112-2466 | 2015-09-29 |
| 1437409901 | Crystal A Nelson | Physician Assistant | 9350 E 35th St N, Ste 101, Wichita, KS 67226 | 2012-09-12 |
| 1306195193 | Jessica M Hughbanks | Physician Assistant | 101 Industrial Rd, Hillsboro, KS 67063-9602 | 2012-09-07 |
| 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.