Jared McKinley Grantham, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1-137611 Issued in AL

Practice address

1108 Ross Clark Cir
Dothan, AL 36301-3022

Phone

(334) 793-8087

Fax

(334) 793-8191

NPI assigned

Dec 11, 2012

Last updated

Dec 11, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holmes County Hospital CorpGroup PAC ID 3375557887, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Doctors Memorial Hospital Hospital, Bonifay, FL, CCN 101307

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Holmes County Hospital Corp

  dba Doctors Memorial Hospital

  • Critical Access Hospital
  • Bonifay, FL
  • NPI 1366431702
  Medicare reassignment Care Compare group NPD
• Northwest Florida Healthcare, Inc

  • Critical Access Hospital
  • Chipley, FL
  • NPI 1336163708
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba Southeast Reference Services

  • Clinical Medical Laboratory
  • Dothan, AL
  • NPI 1114161601
  NPD
• Houston County Healthcare Authority

  dba SAMC- Profee Billing

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134

  Nurse Anesthetist, Certified Registered

  NPD
• Medcore Associates, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1992524607
  NPD
• Pathology Laboratory Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1134190648
  NPD
• Holmes County Hospital Corp

  dba Bonifay Rural Health Clinic

  • Rural Health Clinic/Center
  • Bonifay, FL
  • NPI 1952917015
  NPD
• Northwest Florida Healthcare, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Chipley, FL
  • NPI 1659438760
  NPD
• The Pathology Group of Northwest Florida PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1114153269
  NPD
• Vivid Pathology PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
  • NPI 1760738611
  NPD

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

• Holmes County Hospital Corp

  dba Doctors Memorial Hospital

  • Critical Access Hospital
  • Bonifay, FL
  • NPI 1366431702
  Care Compare affiliation

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1134464506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1928",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363021928",
            "telephone_number": "334-793-8087",
            "fax_number": "334-793-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-793-8087",
            "fax_number": "334-793-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "JARED",
        "middle_name": "MCKINLEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-137611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S Graham, MD
• Leona Jean Graham, M.D.
• Lori P. Granberry, RPH
• Mallory Granger, OTR/L
• Candace Reynolds Grantham, CRNA
• Elizabeth Graves, LCSW
• Brianna Lynn Grayson, MS, LPC, ADC, QSAP I
• Amelia Carlyle Greathouse, FNP-C
• Hunter Michael Green, DO
• Cameron Gregg

• Certified Registered Nurse Anesthetist in Dothan, AL
• Providers in Dothan, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.