Grand Medical Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

251159 Issued in TX

Legal business name

GRAND MEDICAL CLINIC

Doing business as

Susan Baltz

Practice address

1416 S Hayden St
Amarillo, TX 79102-1635

Phone

(806) 374-1919

Fax

(806) 379-9213

NPI assigned

Nov 1, 2006

Last updated

Nov 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan A Baltz, FAMILY NURSE PRACTITNPI 1992919484

Title

Family Nurse Practitioner Owner

Phone

(806) 374-1919

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Susan Baltz Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan A Baltz, FNP

  • Family Nurse Practitioner
  • Amarillo, TX
  • NPI 1992919484
  NPD (past) Authorized official
• Eric C. Cox, M.D.

  • Family Medicine Physician
  • Amarillo, TX
  • NPI 1578560231
  NPD (past)
• Leonardo Ernesto Salcedo, MD

  • Cardiovascular Disease Physician
  • Edinburg, TX
  • NPI 1407975048
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1265519623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 S HAYDEN ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791021635",
            "telephone_number": "806-374-1919",
            "fax_number": "806-379-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 S HAYDEN ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791021635",
            "telephone_number": "806-374-1919",
            "fax_number": "806-379-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "BALTZ",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER OWNER",
        "authorized_official_telephone_number": "806-374-1919",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FAMILY NURSE PRACTIT"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "251159",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K2883",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHIC",
            "identifier": "092280502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8P0790",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092282501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan Baltz",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candy Graham
• Jennifer Graham
• Brenda Granados Garcia, MS CCC SLP
• Claudia Granados, FNP
• Sarai Granados, M.S., CCC-SLP
• Constance Sue Grant I, COTA
• Miles W Grant, MD
• Ruth Elizabeth Grant, MD
• Adam Graves
• Amanda Graves, M.S. CCC-SLP, CLC

• Family Nurse Practitioner in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.