Active NPI
Rachel Elizabeth Granberg, MD, MPH
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1003492877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2024015146
- Practice address
- 1 Childrens PL MSC 8116-0043-09
Saint Louis, MO 63110 - Phone
- (314) 454-6018
- Fax
- (844) 621-4392
- NPI assigned
- Mar 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2024015146 | MO | Primary |
| Pediatrics Physician | 208000000X | 94-10628 | KS |
Addresses
Primary practice location
1 Childrens PL MSC 8116-0043-09
Saint Louis, MO 63110
Mailing address
1 Childrens PL MSC 8116-0043-09
Saint Louis, MO 63110
Phone (314) 454-6018
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210624000532 | MO | Order and Referring Only - Pediatric Medicine | 4183025497 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94-10628 | KS | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1003492877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL MSC 8116-0043-09",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63110",
"telephone_number": "314-454-6018",
"fax_number": "844-621-4392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL MSC 8116-0043-09",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63110",
"telephone_number": "314-454-6018",
"fax_number": "844-621-4392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANBERG",
"first_name": "RACHEL",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-22",
"last_updated": "2024-06-24",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2024015146",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "94-10628",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
- Rebecca Lindsay Grammer, D.M.D., M.D.
- Lori Leigh Gran, PHYSICAL THERAPIST
- Amber Grana, DO
- Julie Grana, MA OTR/L, LBA, BCBA
- Jorge Granadillo de Luque, MD
- Steven J Granberg, MD
- Grand Manor Health Care Center, L.L.C.
- Grand Manor Nursing & Rehabilitation Center, L.L.C.
- Grand Manor SNF Opco LLC
- Grand Medical Group LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.