Alissa Michelle Grant, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E-7744 Issued in AR

Practice address

900 Highway 71 N
Mena, AR 71953-4304

Phone

(479) 394-5439

Fax

(479) 394-4357

NPI assigned

Jul 20, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18246/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mena Pediatric Center, PLLC

  • Pediatrics Physician
  • Mena, AR
  • NPI 1164909081
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1003016700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HIGHWAY 71 N",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534304",
            "telephone_number": "479-394-5439",
            "fax_number": "479-394-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HIGHWAY 71 N",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534304",
            "telephone_number": "479-394-5439",
            "fax_number": "479-394-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ALISSA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-7744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafael Gomez, M.D.
• Goodnight Family Healthcare PLLC
• Gretchen Laurel Goodnight, ANP
• Cassidy Joy Marie Gorman
• Brandyn Gortemiller, COTA
• Adam Gunn, PT, DPT, OCS
• Hailee Elizabeth Rutherford FNP-C PLLC
• Howard Leon Hall, O.D.
• Mark C Hamelink, CRNA
• Keisha Hankins

• Pediatrics Physician in Mena, AR
• Providers in Mena, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.