Alexa Blaire Grand, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-922 Issued in AR

Practice address

500 S 52ND St
Rogers, AR 72758-8600

Phone

(479) 254-9662

Fax

(806) 701-5845

NPI assigned

Nov 6, 2017

Last updated

Aug 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alexa Blaire Vessell Former name

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hull Dermatology P.a.Group PAC ID 1759433881, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as group

Quality

95

Promoting interoperability

96

Improvement activities

40

Cost

92.8

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Hull Dermatology P.a.

  • Medical Specialty Clinic/Center
  • Rogers, AR
  • NPI 1407082464
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1093228520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 52ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588600",
            "telephone_number": "479-254-9662",
            "fax_number": "479-254-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 52ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588600",
            "telephone_number": "479-254-9662",
            "fax_number": "806-701-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAND",
        "first_name": "ALEXA",
        "middle_name": "BLAIRE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXA",
            "last_name": "VESSELL",
            "middle_name": "BLAIRE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Elaine Goucher, APRN, WHNP-BC
• Lindsey Ann Goucher, APRN
• GPB Enterprises LLC
• Alyssa Eden Graff, PA
• Corey Kendall Graham, PT
• Phebe Joy Granderson, CNM
• Grant J Fowler D.D.S.
• Patrick Michael Grant Jr.
• Kelly B Gray, LCSW
• Rachel Gray

• Physician Assistant in Rogers, AR
• Providers in Rogers, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.