Grady Mark McMahan, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J6584 Issued in TX

Practice address

4101 Wesley St
Ste C
Greenville, TX 75401-5635

Phone

(903) 454-8111

Fax

(903) 454-1680

NPI assigned

May 31, 2005

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

Other identifiers 2

Other names 1

• Grady Mark McMahan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814
  NPD (past)
• Suzanne E Monday MD

  • Family Medicine Physician
  • Commerce, TX
  • NPI 1659411742
  NPD (past)

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205839537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 WESLEY ST",
            "address_2": "STE C",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015635",
            "telephone_number": "903-454-8111",
            "fax_number": "903-454-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 WESLEY ST",
            "address_2": "STE C",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015635",
            "telephone_number": "903-454-8111",
            "fax_number": "903-454-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "GRADY",
        "middle_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00217687",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8J1203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRADY",
            "last_name": "MCMAHAN",
            "middle_name": "MARK",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• McGaughey-Creswell-Mann, Inc
• Christi McGraw, PT
• Mci Home Health Services,Corp
• Dawn Charee McKinney Botefuhr, M.ED., LPC-S, NCC
• Andrew M McLane
• Madrina McMahan
• Joni McMillan, OTA
• Sheila McMurray, R.PH.
• Martha L McQuaid, M.D.
• Liesl McQuillan, LPC, LSOTP

• Family Medicine Physician in Greenville, TX
• Providers in Greenville, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.