NPIMap

Individual provider Active NPI

Grant Lannoye, PA-C

  • Medical Physician Assistant
  • Cando, ND
National Provider Identifier
1093184657
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PAC0615 Issued in ND
Practice address
7448 US Hwy 281
Cando, ND 58324-0688
Phone
(701) 968-2541
Fax
(701) 968-2574
NPI assigned
Sep 24, 2015
Last updated
Sep 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PAC0615 ND Primary

Addresses

Primary practice location

7448 US Hwy 281
Cando, ND 58324-0688

Mailing address

PO Box 688
Cando, ND 58324-0688
Phone (701) 968-2541

Other identifiers 1

IdentifierTypeStateIssuer
PAC0615OtherNDNORTH DAKOTA LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20151124002621 ND Practitioner - Physician Assistant 7214237163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Towner County Medical Center IncGroup PAC ID 6800798497, shared by 4 NPIs, 12 clinicians

Practice addresses (Care Compare)

228 1St Ave
Cando, ND 58324-7500
Phone (701) 968-2541

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAC0615NDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Towner County Medical Center Inc CurrentSince Oct 12, 2015 Accepting new patients
Towner County Medical Center Inc Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1093184657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 688",
            "city": "CANDO",
            "state": "ND",
            "postal_code": "583240688",
            "telephone_number": "701-968-2541",
            "fax_number": "701-968-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7448 US HWY 281",
            "city": "CANDO",
            "state": "ND",
            "postal_code": "583240688",
            "telephone_number": "701-968-2541",
            "fax_number": "701-968-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANNOYE",
        "first_name": "GRANT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH DAKOTA LICENSE NUMBER",
            "identifier": "PAC0615",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cando, ND

Sources for this page

Verify at the official NPI Registry.