NPIMap

Individual provider Active NPI

Paul R. Granzow, PA-C

  • Medical Physician Assistant
  • Forest City, NC
National Provider Identifier
1104908748
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
101884 Issued in NC
Practice address
181 Daniel Rd
Forest City, NC 28043-7151
Phone
(828) 286-9036
Fax
(828) 286-1079
NPI assigned
Oct 20, 2006
Last updated
Aug 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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 101884 NC Primary

Addresses

Primary practice location

181 Daniel Rd
Forest City, NC 28043-7151

Mailing address

PO Box 602148
Charlotte, NC 28260-2148
Phone (828) 286-9036

Other identifiers 3

IdentifierTypeStateIssuer
8101814MedicaidNC
1104908748MedicaidNC
970027367OtherMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090507000663 NC Practitioner - Physician Assistant 3375691991 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Eldercare PAGroup PAC ID 0648184705, 236 clinicians
Curana Health of North Carolina PLLCGroup PAC ID 1850774332, 274 clinicians

Practice addresses (Care Compare)

4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone (336) 251-1114

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Aug 14, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 14, 2023 Accepting new patients
Rutherford Internal Medicine Associates PA Past Accepting new patients
Rutherford Internal Medicine Associates PA Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

181 Daniel Rd
Forest City, NC 28043
Phone (828) 286-9036

Organizations & group practices 9

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1104908748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602148",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602148",
            "telephone_number": "828-286-9036",
            "fax_number": "828-286-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 DANIEL RD",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280437151",
            "telephone_number": "828-286-9036",
            "fax_number": "828-286-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANZOW",
        "first_name": "PAUL",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8101814",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104908748",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "970027367",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, NC

Sources for this page

Verify at the official NPI Registry.