Individual provider Active NPI

James R Granger III, MD

  • General Practice Physician
  • Marietta, GA
National Provider Identifier
1073714580
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
55824 Issued in GA
Practice address
1521 Johnson Ferry Rd Ste 135
Marietta, GA 30062-6408
Phone
(678) 247-2115
Fax
(404) 393-8059
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 55824 GA Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X 55824 GA
Pain Medicine Physician 208VP0000X 55824 GA

Addresses

Primary practice location

1521 Johnson Ferry Rd Ste 135
Marietta, GA 30062-6408

Mailing address

1521 Johnson Ferry Rd Ste 135
Marietta, GA 30062-6408
Phone (678) 247-2115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140715000612 GA Practitioner - Pain ManagementPractitioner - General PracticePractitioner - Physical Medicine and RehabilitationPractitioner - Addiction Medicine 9830173012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Addiction Medicine, Physical Medicine and Rehabilitation
Education
Meharry Medical College School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1521 Johnson Ferry Rd
Suite 135
Marietta, GA 30062-6408
Phone (678) 247-2115

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Cobb Spine and Nerve Institute, LLC CurrentSince May 1, 2014 Accepting new patients
Altergyn, LLC General Practice CurrentSince Oct 9, 2018 Accepting new patients
New Life Chiropractic Center LLC Past Accepting new patients
Whitehall Wellness Center PastSince Oct 14, 2021 Accepting new patients

Locations

3451 Cobb Pkwy NW
Ste 4
Acworth, GA 30101
Phone (678) 574-5678

413 Pottery Factory Dr
Commerce, GA 30529
Phone (706) 423-9449

1521 Johnson Ferry Rd
Ste 135
Marietta, GA 30062
Phone (678) 247-2115

3823 Roswell Rd
Ste 201
Marietta, GA 30062
Phone (678) 247-2115

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDBADD/Endpoint/GDBADD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1073714580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 JOHNSON FERRY RD STE 135",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626408",
            "telephone_number": "678-247-2115",
            "fax_number": "404-393-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 JOHNSON FERRY RD STE 135",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626408",
            "telephone_number": "678-247-2115",
            "fax_number": "404-393-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "JAMES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "55824",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "GA",
            "license": "55824",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "55824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.