Carol Luisa Grant-Dougherty, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11959 Issued in CA

Practice address

43839 15TH St W
Lancaster, CA 93534-4756

Phone

(661) 945-5984

Fax

(661) 951-3357

NPI assigned

Aug 30, 2006

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

• Carol Luisa Grant Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• High Desert Medical Group

  • Multi-Specialty Clinic/Center
  • Lancaster, CA
  • NPI 1720196702
  Medicare reassignment

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1114037579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7007",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935397007",
            "telephone_number": "661-945-5984",
            "fax_number": "661-951-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43839 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344756",
            "telephone_number": "661-945-5984",
            "fax_number": "661-951-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT-DOUGHERTY",
        "first_name": "CAROL",
        "middle_name": "LUISA",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "GRANT",
            "middle_name": "LUISA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sylvia V Granados
• Francisco Roberto Grande, PT
• Julia E Granese, FNP
• Rosemary Granger
• Carol Louise Granlund, PSY.D.
• Terrill Grant
• Amanda Jo Graves, RN, MSN
• Porsha K Gray, PMHNP-BC
• William Gray
• Judith Lynn Grayson

• Physician Assistant in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.