Individual provider Active NPI

Andrew Alan Grant, S.L.P

  • Speech-Language Pathologist
  • Glendale, CA
National Provider Identifier
1245431006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP9278 Issued in CA
Practice address
411 No Central Ave
Suite 300
Glendale, CA 91203
Phone
(818) 549-9764
Fax
(818) 549-9767
NPI assigned
May 30, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP9278 CA Primary

Addresses

Primary practice location

411 No Central Ave
Suite 300
Glendale, CA 91203

Mailing address

1230 E Washington St
Suite 2
Colton, CA 92324-6450
Phone (909) 825-6716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP9278CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
United Therapy Network Incorporated Speech-Language Pathologist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245431006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 E WASHINGTON ST",
            "address_2": "SUITE 2",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923246450",
            "telephone_number": "909-825-6716",
            "fax_number": "909-825-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 NO CENTRAL AVE",
            "address_2": "SUITE 300",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91203",
            "telephone_number": "818-549-9764",
            "fax_number": "818-549-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ANDREW",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "S.L.P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP9278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.