Mr Blake Jon Grove, MS, RD is a
Dietitian, Registered based in Ormsby, Minnesota. Mr Blake Jon Grove is licensed to practice in Mississippi (license number D2308) and his current practice location is
218 Broadway Ave, Ormsby, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(507) 848-6112.
NPI number for Mr Blake Jon Grove is 1386365021 and his current mailing address is 218 Broadway Ave, Ormsby, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1386365021.
Healthcare Provider's Profile
| Full Name | Mr Blake Jon Grove |
|---|
| Gender | Male |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 218 Broadway Ave, Ormsby, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1386365021
- Provider Enumeration Date: 09/12/2022
- Last Update Date: 09/12/2022
Medical Identifiers
Medical identifiers for Mr Blake Jon Grove such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386365021 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | D2308 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Blake Jon Grove is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Blake Jon Grove, MS, RD
218 Broadway Ave,
Ormsby, MN 56162-4004
Ph: (507) 848-6112 | Mr Blake Jon Grove, MS, RD
218 Broadway Ave,
Ormsby, MN 56162-4004
Ph: (507) 848-6112 |
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