Individual provider Active NPI

William Grant Jr., MD

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1013989862
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200100041 Issued in NC
Practice address
11200 Governor Manly Way
Raleigh, NC 27614-8599
Phone
(919) 747-5270
Fax
(919) 747-5271
NPI assigned
Feb 6, 2006
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200100041 NC Primary

Addresses

Primary practice location

11200 Governor Manly Way
Raleigh, NC 27614-8599

Mailing address

11200 Governor Manly Way
Raleigh, NC 27614-8599
Phone (919) 570-7660

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wgrant6864@direct.UNC.nchie.net Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708001181 NC Practitioner - Family Practice 1052399839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

11200 Governor Manly Way
Suite 114
Raleigh, NC 27614-7360
Phone (919) 570-7660

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200100041NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC CurrentSince Jun 1, 2025 Accepting new patients
North Carolina Emergency Physicians, PLLC PastSince Feb 9, 2020 Accepting new patients
Unc Physicians Network LLC Family Medicine Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

6602 Knightdale Blvd
Ste 201
Knightdale, NC 27545
Phone (919) 747-5270

6602 Knightdale Blvd
Ste 202
Knightdale, NC 27545
Phone (919) 747-5270

11200 Governor Manly Way
Ste 114
Raleigh, NC 27614
Phone (919) 570-7660

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: wgrant6864@direct.unc.nchie.net

Organizations & group practices 5

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1013989862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 GOVERNOR MANLY WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148599",
            "telephone_number": "919-570-7660",
            "fax_number": "919-570-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 GOVERNOR MANLY WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148599",
            "telephone_number": "919-747-5270",
            "fax_number": "919-747-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200100041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wgrant6864@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CDA/CCD/TXT",
            "address_1": "11200 Governor Manly Way",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276148599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.