Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Mallory Williams Grose, ANP-C

Individual provider Nurse Practitioner · NPI 1093089575

Mrs. Mallory Williams Grose, ANP-C is a Nurse Practitioner in Mount Airy, North Carolina. Qualified in 2011, 15 years ago. Practices with Forsyth Memorial Hospital Inc, a 623-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
15
Licensed in
NC
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

694 Riverside Dr
Mount Airy, NC 27030
Phone: (336) 719-7892
Fax: (336) 719-7898
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 905 Rockford St, Mount Airy, NC 27030-5323 — (336) 719-2440
  • 905 Rockford St, Mount Airy, NC 27030-5323 — (336) 719-2440

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5005508 (NC)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 363LA2200X (NC)

Record details

NPI number1093089575
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP-C
Sole proprietorNo
NPI enumeratedMarch 1, 2012
Last updated in NPPESAugust 2, 2024
Certification dateAugust 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Forsyth Memorial Hospital Inc — 623 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Mount Airy