Individual provider Active NPI

Grant Anderson, PA-C

  • Physician Assistant
  • Hendersonville, TN
National Provider Identifier
1003279589
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2972 Issued in TN
Practice address
211 Indian Lake Bloulevard
Hendersonville, TN 37075
Phone
(615) 826-3100
Fax
(615) 447-1059
NPI assigned
Apr 1, 2016
Last updated
Apr 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2972 TN Primary

Addresses

Primary practice location

211 Indian Lake Bloulevard
Hendersonville, TN 37075

Mailing address

513 Saint Blaise Rd
Gallatin, TN 37066-4449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170731000258 TN Practitioner - Physician Assistant 0446521181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hermitage Family Practice LLCGroup PAC ID 9739567116, 2 clinicians

Practice addresses (Care Compare)

4243 Lebanon Pike
Suite a
Hermitage, TN 37076-2170
Phone (615) 874-9888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3880/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1003279589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 SAINT BLAISE RD",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370664449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 INDIAN LAKE BLOULEVARD",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "37075",
            "telephone_number": "615-826-3100",
            "fax_number": "615-447-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GRANT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

Verify at the official NPI Registry.