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NPI Code Detail

MEDICARE: KIRBY GROOVER PA-C

MEDICARE:   KIRBY  GROOVER  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant3798TN

General Provider Information

NPI Number : 1902368921
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRBY GROOVER PA-C
Provider Business Mailing Address
First Line : 10001 W INNOVATION DR STE 200
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-4851
Country : US
Telephone Number : 888-938-3838
Fax Number : 888-919-1083
Provider Business Practice Location Address
First Line : 3333 ASPEN GROVE DR STE 100
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-4875
Country : US
Telephone Number : 888-938-3838
Fax Number : 888-919-1083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2019
Last Update Date : 02/18/2026

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Directions to “ KIRBY GROOVER PA-C” Practice Location

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