Khristopher Michael Grant, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12403 Issued in MN

Practice address

3100 Kennard St Ste 100
Maplewood, MN 55109-5466

Phone

(651) 232-7800

NPI assigned

Jun 12, 2017

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 MN

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

Tufts University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment Care Compare group
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  • Health Service Clinic/Center
  • Saint Paul, MN
  • NPI 1215129853
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Burnsville, MN
  • NPI 1083806772
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  • Hospitalist Physician
  • Princeton, MN
  • NPI 1013097377
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Healtheast Medical Research Institute

  • Clinic/Center
  • Saint Paul, MN
  • NPI 1184670044
  NPD
• Healtheast Medical Research Institute

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552
  NPD

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194255224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 TRAILWAY DR APT 8",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 KENNARD ST STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095466",
            "telephone_number": "651-232-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 Woodwinds Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551252202",
            "country_code": "US",
            "telephone_number": "651-232-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "KHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Kay Grace, FNP
• Caprice Dorlee Graham, LADC, BCCR
• Grand St Paul CVS LLC
• Thomas E Grande, MD
• Nancy C Grandt, CNP
• Robin Christine Grant
• Beau Martin Gray, LPCC
• Flete Warren Gray, PA
• Steven Powers Gray, M.A.
• Leigh Ann Greavu, RD LD

• Physician Assistant in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.