Mark Edward McGranahan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-111323 Issued in IL

Practice address

1230 George E. Chance Parkway
Caseyville, IL 62232

Phone

(618) 345-5437

NPI assigned

Sep 16, 2005

Last updated

Aug 13, 2008By 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 IL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: markmcgranahan@atoz.directglo.com
• Direct secure messaging: mmcgrana@yourcarecommunity.org

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.

• Granite City Hospitalist Services LLC

  • Hospitalist Physician
  • Carbondale, IL
  • NPI 1669926424
  Medicare reassignment NPD
• A to Z Pediatrics, LLP

  • Pediatrics Physician
  • Caseyville, IL
  • NPI 1053577387
  NPD (past)

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1215922000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 GEORGE E. CHANCE PARKWAY",
            "city": "CASEYVILLE",
            "state": "IL",
            "postal_code": "62232",
            "telephone_number": "618-345-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 GEORGE E. CHANCE PARKWAY",
            "city": "CASEYVILLE",
            "state": "IL",
            "postal_code": "62232",
            "telephone_number": "618-345-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRANAHAN",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-111323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawna Renae Galonda Herndon, LMT
• Melissa Hill, CPNP-PC
• Hollywood Heights Fire Department
• B Jo R Hughes
• Ky a. Miller, LLC
• Gina Marie Molton, LPTA
• Desiree Lynette Norberg, D.C.
• Curtis D Osborne, LCSW
• Tanvi Patel, FNP-BC
• Jessica Penny

• Pediatrics Physician in Caseyville, IL
• Providers in Caseyville, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.