NPIMap

Individual provider Active NPI

Lance A Grammont, DO

  • Family Medicine Physician
  • Appleton, WI
National Provider Identifier
1063459790
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49656 Issued in WI
Practice address
3925 N Gateway Dr
Appleton, WI 54913-7863
Phone
(920) 830-6877
Fax
(920) 454-7013
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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 49656 WI Primary

Addresses

Primary practice location

3925 N Gateway Dr
Appleton, WI 54913-7863

Mailing address

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone (920) 830-6877

Other practice location 1

3329 N Richmond St
Appleton, WI 54911-1063
Phone (920) 380-2727

Other practice location 2

333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 830-6877

Other identifiers 1

IdentifierTypeStateIssuer
37582500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080913000046 WI Practitioner - Family Practice 6305912429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone (920) 454-8401

Hospital & facility affiliations

  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49656WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Dec 20, 2022 Accepting new patients
Thedacare, Incorporated Family Medicine CurrentSince Dec 20, 2022 Accepting new patients

Locations

3925 N Gateway Dr
Appleton, WI 54913
Phone (920) 702-6371

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

333 N Green Bay Rd
Neenah, WI 54956
Phone (920) 725-2070

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: lgrammont15935@direct.thedacare.org

Organizations & group practices 2

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.

Hospital & facility affiliations 12

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1063459790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 N GATEWAY DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137863",
            "telephone_number": "920-830-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N GATEWAY DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137863",
            "telephone_number": "920-830-6877",
            "fax_number": "920-454-7013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3329 N Richmond St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549111063",
            "country_code": "US",
            "telephone_number": "920-380-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 N Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549561954",
            "country_code": "US",
            "telephone_number": "920-830-6877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAMMONT",
        "first_name": "LANCE",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "49656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37582500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.