Note: DataSpring/CAQH was formerly known as CAQH ProView. If you have an existing CAQH ProView account, your login credentials and profile information carry over — no new account is needed.
Completing these steps accurately prevents delays in your credentialing. If you received a failure notification email, go directly to the section that matches the error described.
On this page:
1️⃣ Log in to Dataspring/CAQH
1️⃣ Log in to Dataspring/CAQH
Go to proview.caqh.org in your browser.
Enter your username and password, then press Sign In.
If you've forgotten your password, click Forgot Password on the login screen and follow the prompts.
If you can't find your DataSpring Provider ID, visit dataspring.com/resources/support for support.
2️⃣ Add Grow Therapy as a practice location
2️⃣ Add Grow Therapy as a practice location
Add your Grow Therapy practice location for each state where you hold an active license and will be seeing patients through Grow Therapy.
From the left menu, select Practice Locations.
Click Add New Practice Location.
Find your state in the accordion below and enter the address shown. Follow the additional prompts within the state to ensure you update all the practice location information accordingly.
Repeat for each additional licensed state using that state's address.
Do not remove or archive your Grow Therapy practice location. Payers treat a missing or inactive location as a signal that you are no longer practicing with Grow Therapy in that state, which can trigger de-credentialing.
Find your state below:
Alabama
Alabama
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 1 Chase Corporate Center |
Street 2 | Suite 400 |
City / state / zip | Birmingham, AL 35244 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Alaska
Alaska
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 721 Depot Drive |
Street 2 | — |
City / state / zip | Anchorage, AK 99501 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Arizona
Arizona
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 4600 E. Washington |
Street 2 | Suite 300 |
City / state / zip | Phoenix, AZ 85034 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Arkansas
Arkansas
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 609 SW 8th Street |
Street 2 | — |
City / state / zip | Bentonville, AR 72712 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
California
California
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group PC |
Virtual-only location | Leave unchecked |
Street 1 | 99 South Almaden Boulevard |
Street 2 | Suite 600 |
City / state / zip | San Jose, CA 95113 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group PC |
Tax ID | 87-1702628 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1154994846 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Colorado
Colorado
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 5445 DTC Parkway |
Street 2 | Penthouse 4 |
City / state / zip | Greenwood Village, CO 80111 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Connecticut
Connecticut
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 100 Pearl St |
Street 2 | FL 14 |
City / state / zip | Hartford, CT 06103 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Delaware
Delaware
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 200 Continental Drive |
Street 2 | Suite 401 |
City / state / zip | Newark, DE 19713 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
District of Columbia
District of Columbia
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 1140 3rd Street NE |
Street 2 | — |
City / state / zip | Washington, DC 20002 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Florida
Florida
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 66 W Flagler St |
Street 2 | Suite 900 |
City / state / zip | Miami, FL 33130 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Georgia
Georgia
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 1055 Howell Mill Rd |
Street 2 | 8th Floor |
City / state / zip | Atlanta, GA 30318 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Hawaii
Hawaii
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 500 Ala Moana Blvd |
Street 2 | Suite 7400 |
City / state / zip | Honolulu, HI 96813 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Idaho
Idaho
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 950 Bannock Street |
Street 2 | Suite 1100 |
City / state / zip | Boise, ID 83702 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Illinois
Illinois
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 203 North LaSalle |
Street 2 | Suite 2100 |
City / state / zip | Chicago, IL 60601 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Indiana
Indiana
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 9465 Counselors Row |
Street 2 | Suite 200 |
City / state / zip | Indianapolis, IN 46240 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Iowa
Iowa
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 699 Walnut Street |
Street 2 | 4th Floor |
City / state / zip | Des Moines, IA 50309 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Kansas
Kansas
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group of Kansas PA |
Virtual-only location | Leave unchecked |
Street 1 | 801 E. Douglas Avenue |
Street 2 | 2nd Floor |
City / state / zip | Wichita, KS 67202 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group of Kansas PA |
Tax ID | 88-1289873 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1831848316 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Kentucky
Kentucky
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 312 S. Fourth Street |
Street 2 | Suite 700 |
City / state / zip | Louisville, KY 40202 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Louisiana
Louisiana
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | One Galleria Blvd |
Street 2 | Suite 1900 |
City / state / zip | Metairie, LA 70001 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Maine
Maine
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 63 Federal Street |
Street 2 | — |
City / state / zip | Portland, ME 04101 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Maryland
Maryland
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 3 Bethesda Metro Center |
Street 2 | Suite 700 |
City / state / zip | Bethesda, MD 20814 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Massachusetts
Massachusetts
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 100 Cambridge Street |
Street 2 | 14th Floor |
City / state / zip | Boston, MA 02114 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Michigan
Michigan
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 250 Monroe NW |
Street 2 | Suite 400 |
City / state / zip | Grand Rapids, MI 49503 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Minnesota
Minnesota
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 2355 Highway 36 West |
Street 2 | Suite 400 |
City / state / zip | Roseville, MN 55113 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Mississippi
Mississippi
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 232 Market Street |
Street 2 | — |
City / state / zip | Flowood, MS 39232 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Missouri
Missouri
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 4625 Lindell Blvd |
Street 2 | Suite 200 & 300 |
City / state / zip | St. Louis, MO 63108 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Montana
Montana
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 5 West Mendenhall Street |
Street 2 | Suite 202 |
City / state / zip | Bozeman, MT 59715 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Nebraska
Nebraska
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 14301 FNB Parkway |
Street 2 | Suite 100 |
City / state / zip | Omaha, NE 68154 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Nevada
Nevada
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 3753 Howard Hughes Parkway |
Street 2 | Suite 200 |
City / state / zip | Las Vegas, NV 89169 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
New Hampshire
New Hampshire
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 170 Commerce Way |
Street 2 | Suite 200 |
City / state / zip | Portsmouth, NH 03801 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
New Jersey
New Jersey
New Jersey has two practice locations. You must add both. Complete the steps below for Location 1 (Hoboken), then repeat for Location 2 (Newark).
📍Hoboken
📍Hoboken
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group of New Jersey PC |
Virtual-only location | Leave unchecked |
Street 1 | 221 River Street |
Street 2 | 9th Floor |
City / state / zip | Hoboken, NJ 07030 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group of New Jersey PC |
Tax ID | 88-1265059 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1841949328 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
📍Newark
📍Newark
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group of New Jersey PC |
Virtual-only location | Leave unchecked |
Street 1 | 625 Broad Street |
Street 2 | Suite 240 |
City / state / zip | Newark, NJ 07102 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group of New Jersey PC |
Tax ID | 88-1265059 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1841949328 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
New Mexico
New Mexico
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 500 Marquette Avenue NW |
Street 2 | Suite 1200 |
City / state / zip | Albuquerque, NM 87102 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
New York
New York
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 165 Broadway |
Street 2 | 23rd Floor |
City / state / zip | New York, NY 10006 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
North Carolina
North Carolina
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 2530 Meridian Parkway |
Street 2 | Suite 300 |
City / state / zip | Durham, NC 27713 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
North Dakota
North Dakota
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 3523 45th Street South |
Street 2 | Suite 100 |
City / state / zip | Fargo, ND 58104 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Ohio
Ohio
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 4449 Easton Way |
Street 2 | 2nd Floor |
City / state / zip | Columbus, OH 43219 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Oklahoma
Oklahoma
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 101 Park Avenue |
Street 2 | Suite 1300 |
City / state / zip | Oklahoma City, OK 73102 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Oregon
Oregon
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 10260 SW Greenburg Road |
Street 2 | 4th Floor |
City / state / zip | Portland, OR 97223 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Pennsylvania
Pennsylvania
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 100 South Juniper |
Street 2 | 3rd Floor |
City / state / zip | Philadelphia, PA 19107 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Rhode Island
Rhode Island
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 10 Dorrance Street |
Street 2 | Suite 700 |
City / state / zip | Providence, RI 02903 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24-hour / 7-day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
South Carolina
South Carolina
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 170 Meeting Street |
Street 2 | Suite 110 |
City / state / zip | Charleston, SC 29401 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
South Dakota
South Dakota
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 101 S. Reid Street |
Street 2 | Suite 307 |
City / state / zip | Sioux Falls, SD 57103 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Tennessee
Tennessee
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 40 Burton Hills Boulevard |
Street 2 | Suite 200 |
City / state / zip | Nashville, TN 37215 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Texas
Texas
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 700 Milam St |
Street 2 | Suite 1300 |
City / state / zip | Houston, TX 77002 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Utah
Utah
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 222 S. Main Street |
Street 2 | 5th Floor |
City / state / zip | Salt Lake City, UT 84101 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Vermont
Vermont
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 1 Lawson Lane |
Street 2 | Suite 340 |
City / state / zip | Burlington, VT 05401 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-178 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Virginia
Virginia
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 8300 Boone Blvd |
Street 2 | Suite 500 |
City / state / zip | Vienna, VA 22181 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Washington
Washington
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 1455 NW Leary Way |
Street 2 | Suite 400 |
City / state / zip | Seattle, WA 98107 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
West Virginia
West Virginia
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 1038 Quarrier St |
Street 2 | Suite 100 |
City / state / zip | Charleston, WV 25301 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Wisconsin
Wisconsin
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 4321 W. College Avenue |
Street 2 | Suite 200 |
City / state / zip | Appleton, WI 54914 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Wyoming
Wyoming
PRACTICE LOCATION NAME
Practice location name | Grow Healthcare Group P.A. |
Virtual-only location | Leave unchecked |
Street 1 | 1603 Capitol Avenue |
Street 2 | Suite 413 |
City / state / zip | Cheyenne, WY 82001 |
DIGITAL DIRECTORY INFORMATION
Practice location email | |
Practice location website | |
Appointment scheduling website |
PHONE NUMBERS
Appointment phone number | (646) 760-2248 |
Fax number | 954-480-1784 |
BUSINESS IDENTIFIERS
Legal business name | Grow Healthcare Group P.A. |
Tax ID | 85-2938829 |
Type of Tax ID | Group |
ORGANIZATION (TYPE 2) NPI
Organization (Type 2) NPI | 1245845932 |
TYPE OF PRACTICE
Type of practice | Group |
Next step | Select the "Save and Continue" button |
AFFILIATION
Please describe your affiliation with this location | I see patients by appointment at least one day per month, but less than one day per week on a regular basis. |
PROVIDER START DATE
Provider's start date | Use the date on which you are entering this information into your profile |
SPECIALTY
Specialty | Select your individual specialty |
PATIENTS
Accept all new patients? | Yes |
Accept new patients at this location? | Yes |
Accept existing patients with change of payor? | Yes |
Accept new Medicare patients? | Yes |
Accept new Medicaid patients? | Yes |
Accept new CHIP patients? | Yes |
Accept patients from physician referrals? | Yes |
Does the above vary by health plan? | No |
Next step | Select the "Save and Continue" button |
TELEHEALTH
I provide telehealth services | Yes |
HIPAA-compliant telehealth platform? | Yes |
Telehealth service type | Audio/Video |
OFFICE PERSONNEL
Support type | Office Manager/Business Staff Contact |
First name | Marissa |
Last name | Letendre |
Email address |
PHONE COVERAGE
24 hour / 7 day coverage | Check ✓ this box |
Phone coverage type | Voice Mail Other |
Next step | Select the "Save and Continue" button |
Once you have added all of your practice locations, select the Save and Continue button.
3️⃣ Add Grow Therapy credentialing contact
3️⃣ Add Grow Therapy credentialing contact
This allows Grow Therapy's credentialing team to access and verify your profile on your behalf.
Go to Credentialing Contacts.
Select Add.
Enter Grow Therapy's information using the details below.
Select the dropdown under Location Type and choose Practice Location.
A box will appear that says Location. In this box, select all Grow Healthcare Group PA locations.
Select Save and Continue.
Grow Therapy credentialing contact
First name | Alex |
Last name | Wilson |
Street 1 | 345 Heritage Ave, #930 |
City | Portsmouth |
State | NH |
Zip Code | 03801 |
Country | United States |
Phone number | (617) 917-2389 |
Primary credentialing contact | "Yes" if Grow Therapy is the only location within your DataSpring/CAQH |
Location type | Practice location |
Location | Grow Healthcare Group PA |
Once you have added the Credentialing Contact, select the Save and Continue button.
4️⃣ Add Grow Therapy as a current employer
4️⃣ Add Grow Therapy as a current employer
List Grow Therapy as a current employer in your work history, even if you are a contractor or if this is a secondary practice.
From the left menu, select Employment Information.
Click Add.
Fill in the employer details below using your primary licensed state's address.
Enter the start date as the date on which you are entering this information into your profile.
Is this your current employer? Select Yes.
Select Save and Continue.
Grow Therapy employment information
Practice/employer name | Grow Healthcare Group |
Address | Use the same address that you added in locations. If you added more than one, select the address for your primary practice state. |
Phone number | Add the same phone number you added in locations. If you added more than one, select the address for your primary practice state. |
Fax number | 954-480-1784 |
Start date | Enter/use the date on which you are entering this information into your profile |
Is this your current employer? | Yes |
Next step | Select the "Save and Continue" button |
Avoid unexplained gaps in your work history. Any period of six months or longer without documented employment will be flagged by DataSpring/CAQH and requires a written explanation, which can delay credentialing.
Once you have added the Employment Information, select the Save and Continue button
5️⃣ Update your authorization settings
5️⃣ Update your authorization settings
Grow Therapy must be authorized to access your DataSpring/CAQH profile. Without this step, credentialing cannot proceed.
Select Authorize in the upper right side of your DataSpring/CAQH profile.
Under Authorization Setting, choose whether DataSpring/CAQH should automatically authorize access when an organization subscribes to your data.
Select Yes. Release my data to any organization that requests access. (Recommended)
Check the box confirming "I hereby authorize the release of my full set of DataSpring/CAQH self-reported information as indicated above."
Click Save.
Selecting Yes grants Grow Therapy, its affiliated payors, and other credentialing partners immediate access to your profile, helping avoid delays in the credentialing process.
6️⃣ Attest and submit your profile
6️⃣ Attest and submit your profile
After making all updates, providers must complete their full DataSpring/CAQH profile in order to re-attest. Until a profile is attested, it remains inaccessible to Grow Therapy, its affiliated payors, and other credentialing partners.
Prior to attestation, providers are responsible for verifying that all profile information — particularly licensure — is current and accurate. Attestation constitutes an affirmative representation that the profile reflects your present credentials; DataSpring/CAQH and its participating credentialing organizations rely on this representation without independent verification at the time of submission. Providers must therefore maintain and re-attest their profile on a recurring 120-day cadence. Should a provider obtain an additional license subsequent to initial attestation, the practice location steps outlined in Section 2 must be repeated for the newly licensed state to ensure the profile accurately reflects the provider's expanded scope of practice.
Review all sections for completeness.
Select the red Review and Attest button on the right side of your DataSpring/CAQH profile.
Read the attestation statement.
Click Attest. You will see a confirmation screen with your attestation date.
DataSpring/CAQH attestation expires every 120 days. If your attestation is expired, Grow Therapy cannot access your profile. Re-attest promptly if prompted.
7️⃣ Common errors and how to fix them
7️⃣ Common errors and how to fix them
⚠️ "Profile not attested"
Your profile was updated, but not re-attested. Go to Authorizations & Attestation and complete the attestation step.
⚠️ "Attestation expired"
DataSpring/CAQH attestations expire every 120 days. Log in to DataSpring/CAQH and re-attest. This only takes a few minutes.
⨂ "Grow Therapy not listed as authorized organization"
You haven't granted Grow Therapy access to your profile. Follow Step 5 to add Grow Therapy as an authorized organization with Full Access.
⨂ "Practice location missing for licensed state"
A practice location is required for every state where you hold an active license. Add a location for each using the address table in Step 2.
⨂ "Work history gap detected"
DataSpring/CAQH requires no gaps in your work history. Check your employment history and fill in any blank periods. If you had a genuine gap, add an explanation entry.
⚠️ "Unable to generate state application PDF"
This usually means your profile isn't fully complete. Check for any sections marked with a red or yellow indicator and fill them in before generating the PDF.
For DataSpring/CAQH issues visit dataspring.com/resources/support.