Individual provider Active NPI

Audrey Louise Grant, M.D.

  • Emergency Medicine Physician
  • Portsmouth, VA
National Provider Identifier
1194765826
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101043829 Issued in VA
Practice address
3636 High St
Portsmouth, VA 23707-3236
Phone
(757) 398-2200
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101043829 VA Primary

Addresses

Primary practice location

3636 High St
Portsmouth, VA 23707-3236

Mailing address

PO Box 634706
Cincinnati, OH 45263-0001
Phone (865) 292-3000

Other identifiers 7

IdentifierTypeStateIssuer
139PJOtherNCBLUE CROSS
P00247878OtherVARAILROAD MEDICARE
64315286MedicaidKY
5900979MedicaidNC
P00328958OtherNCRAILROAD MEDICARE
1194765826MedicaidVA
170709MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, SC, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040426001399 VA Practitioner - Emergency Medicine 7113819053 Reassigns benefits to 2 organizations
I20050404000707 SC Practitioner - Emergency Medicine 7113819053 Reassigns benefits to 1 organization
I20151105000068 DC Practitioner - Emergency Medicine 7113819053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101043829VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jan 1, 2024 Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Sound Physicians Emergency Medicine of South Carolina LLC Emergency Medicine CurrentSince Dec 1, 2016 Accepting new patients
Greenbrier Emergency Services, Inc. Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1194765826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634706",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "865-292-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073236",
            "telephone_number": "757-398-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "AUDREY",
        "middle_name": "LOUISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101043829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "139PJ",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00247878",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64315286",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900979",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00328958",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194765826",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170709",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.