Active NPI
Richard Lee Grant, DPM
- Foot & Ankle Surgery Podiatrist
- Southfield, MI
National Provider Identifier
1073586376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 5901000735
- Practice address
- 29556 Southfield Rd
Suite 107
Southfield, MI 48076 - Phone
- (248) 559-5959
- Fax
- (248) 559-0552
- NPI assigned
- Feb 8, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 5901000735 | MI | Primary |
Addresses
Primary practice location
29556 Southfield Rd
Suite 107
Southfield, MI 48076
Mailing address
581 Fox Pointe Court
Bloomfield Hills, MI 48304-1813
Phone (248) 334-9162
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4418408 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5901000735 | MI | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BC Podiatry PLLC | Foot & Ankle Surgery | Past | Accepting new patients |
| BC Podiatry PLLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Podiatrist
- Berkley, MI
- NPI 1184837890
-
dba Gentle Foot & Ankle Care LLC
- Foot & Ankle Surgery Podiatrist
- Madison Heights, MI
- NPI 1306942842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073586376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "581 FOX POINTE COURT",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483041813",
"telephone_number": "248-334-9162",
"fax_number": "248-334-2114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29556 SOUTHFIELD RD",
"address_2": "SUITE 107",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48076",
"telephone_number": "248-559-5959",
"fax_number": "248-559-0552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "RICHARD",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "MI",
"license": "5901000735",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4418408",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.