Active NPI
Sandra Grant, CRNA
- Anesthesiology Physician
- Winter Park, FL
National Provider Identifier
1073784054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- ARNP 2861772
- Practice address
- 318 Park North CT
Winter Park, FL 32789-2553 - Phone
- (407) 928-1404
- NPI assigned
- Mar 18, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | ARNP 2861772 | FL | Primary |
Addresses
Primary practice location
318 Park North CT
Winter Park, FL 32789-2553
Mailing address
318 Park North CT
Winter Park, FL 32789-2553
Phone (407) 928-1404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G1891A | Other | MEDICARE ID CERTIFICATE |
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
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 2861772 | FL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Lake Anesthesia Services, P.a. | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Certified Registered Nurse Anesthetist
- Clermont, FL
- NPI 1346255056
Anesthesiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283212800000",
"number": "1073784054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 PARK NORTH CT",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327892553",
"telephone_number": "407-928-1404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 PARK NORTH CT",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327892553",
"telephone_number": "407-928-1404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "SANDRA",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-18",
"last_updated": "2010-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ARNP 2861772",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID CERTIFICATE",
"identifier": "G1891A",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.