Jeannine Anne Groll, RDN is a
Dietitian, Registered based in Preston, Idaho. Jeannine Anne Groll is licensed to practice in Utah (license number 363888-4901) and her current practice location is
130 E 3rd S, Preston, Idaho. She can be reached at her office (for appointments etc.) via phone at
(208) 852-2542.
NPI number for Jeannine Anne Groll is 1487328480 and her current mailing address is 106 N Bear River Blfs, Preston, Idaho. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1487328480.
Healthcare Provider's Profile
| Full Name | Jeannine Anne Groll |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 130 E 3rd S, Preston, Idaho |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1487328480
- Provider Enumeration Date: 08/03/2021
- Last Update Date: 01/19/2026
Medical Identifiers
Medical identifiers for Jeannine Anne Groll such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1487328480 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 133V00000X | Dietitian, Registered | D-1334 (Idaho) | Secondary |
| 133V00000X | Dietitian, Registered | 363888-4901 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeannine Anne Groll is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Jeannine Anne Groll, RDN 106 N Bear River Blfs, Preston, ID 83263-5184 Ph: (208) 406-9586 | Jeannine Anne Groll, RDN 130 E 3rd S, Preston, ID 83263-1530 Ph: (208) 852-2542 |
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