Grant Alexander Yelliott II, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1717 S J St
Tacoma, WA 98405-4933

Phone

(253) 426-6660

Fax

(253) 426-6250

NPI assigned

Feb 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Emergency Medicine Services of TN, PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1720785884
  Medicare reassignment
• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264
  Medicare reassignment
• Northwest Physician Associates, Apc

  • Emergency Medicine Physician
  • Federal Way, WA
  • NPI 1407127442
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1013055482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6660",
            "fax_number": "253-426-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLIOTT",
        "first_name": "GRANT",
        "middle_name": "ALEXANDER",
        "name_suffix": "II",
        "credential": "PA C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8490021",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "1493YE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0221347",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica K Yearwood, MD
• Lorrin K Yee, M.D.
• Emily Yi Chun Yeh, M.D.
• Hsushi Yeh, MD
• Feliciamonic Lynn Yelladay, LPN
• Savy Yem
• Ann P. Yeo, C.N.M.
• Tatyana Yeremeyeva Schoepflin, LMP
• Indris Ahmed Yesuf, MD
• Rezika Mohammed Yesuf, MD

• Physician Assistant in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.

Verify at the official NPI Registry.