Active NPI
Alfred Granson Jr., M.D., LLC
- Specialist
- Mansfield, OH
National Provider Identifier
1124128491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 35072595G
- Practice address
- 70 Madison Rd
Mansfield, OH 44905-2831 - Phone
- (419) 589-9700
- Fax
- (419) 589-2731
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 35072595G | OH | Primary |
Addresses
Primary practice location
70 Madison Rd
Mansfield, OH 44905-2831
Mailing address
70 Madison Rd
Mansfield, OH 44905-2831
Phone (419) 589-9700
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2136683 | Medicaid | OH | |
| P00818354 | Other | OH | RAILROAD MEDICARE GROUP |
| 000000142322 | Other | OH | ANTHEM BC/BS OF OHIO |
| DQ1487 | Other | OH | RAILROAD MEDICARE INDIVIDUAL |
| 9387391 | Other | OH | MEDICARE GROUP |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35072595G | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1124128491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 MADISON RD",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449052831",
"telephone_number": "419-589-9700",
"fax_number": "419-589-2731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 MADISON RD",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449052831",
"telephone_number": "419-589-9700",
"fax_number": "419-589-2731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANSON",
"first_name": "ALFRED",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D., LLC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "35072595G",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2136683",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP",
"identifier": "P00818354",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS OF OHIO",
"identifier": "000000142322",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE INDIVIDUAL",
"identifier": "DQ1487",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "9387391",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.