Individual provider Active NPI

John Michael Gransbach, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1265118343
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN321441 Issued in GA
Practice address
1605 Chantilly Dr NE Ste 110
Atlanta, GA 30324-3277
Phone
(404) 785-5437
NPI assigned
Jun 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine Physician 2084P0015X 2023024715 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN321441 GA Primary

Addresses

Primary practice location

1605 Chantilly Dr NE Ste 110
Atlanta, GA 30324-3277

Mailing address

1605 Chantilly Dr NE Ste 110
Atlanta, GA 30324-3277
Phone (404) 785-5437

Other practice location 1

9904 Clayton Rd Ste 135
Saint Louis, MO 63124-1149
Phone (314) 467-8393

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
I20250430001738 GA Order and Referring Only - Nurse Practitioner 9537503016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023024715MOMDPsychosomatic Medicine Physician
RN321441GAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1265118343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 CHANTILLY DR NE STE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243277",
            "telephone_number": "404-785-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 CHANTILLY DR NE STE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243277",
            "telephone_number": "404-785-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9904 Clayton Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631241149",
            "country_code": "US",
            "telephone_number": "314-467-8393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANSBACH",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "MO",
            "license": "2023024715",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN321441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.