Individual provider Active NPI

Edward Keith Grant, PA-C

  • Surgical Physician Assistant
  • Macon, GA
National Provider Identifier
1245236744
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4120 Issued in GA
Practice address
3708 Northside Dr
Macon, GA 31210-2404
Phone
(478) 745-4206
Fax
(478) 254-5463
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4120 GA
Surgical Physician Assistant 363AS0400X 4120 GA Primary

Addresses

Primary practice location

3708 Northside Dr
Macon, GA 31210-2404

Mailing address

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20040614000026 GA Practitioner - Physician Assistant 1658354246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Macon Orthopaedic and Hand Center, PAGroup PAC ID 7911994835, 87 clinicians

Practice addresses (Care Compare)

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4120GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Macon Orthopaedic & Hand Center, PA Physician Assistant CurrentSince Feb 1, 2026 Accepting new patients

Locations

908 Hillcrest Pkwy
Dublin, GA 31021
Phone (478) 272-7411

717 S 8th St
Griffin, GA 30224
Phone (770) 227-4600

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

3708 Northside Dr
Macon, GA 31210
Phone (478) 254-5303

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

3051 Watson Blvd
Ste 525
Warner Robins, GA 31093
Phone (478) 953-4563

Interoperability endpoints

  • Direct secure messaging: egrant433169@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1245236744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-254-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-254-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "EDWARD",
        "middle_name": "KEITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "4120",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "4120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.