Granite Ridge Home Health Nursing Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GRANITE RIDGE HOME HEALTH NURSING CARE, INC.

Doing business as

Granite Ridge Home Health Care

Practice address

1060 Fulton St Ste 714
Fresno, CA 93721-2513

Phone

(559) 977-3952

Fax

(559) 420-0310

NPI assigned

Oct 10, 2017

Last updated

Nov 6, 2025By 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

Frank Kelly, RNNPI 1558871053

Title

Assistant Administrator

Phone

(209) 617-9625

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Granite Ridge Home Health Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275043770. Details of each certification follow.

• CCN 559248 Home health agency · Active · Details

Home health agency certification: CCN 559248

Legal name

GRANITE RIDGE HOME HEALTH NURSING CARE, INC.

Doing business as

GRANITE RIDGE HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 1, 2020

Last certification

Oct 1, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

1060 Fulton St
Ste 714
Fresno, CA 93721-2512

Listed as

Granite Ridge Home Health CareCCN 559248 · All quality measures

Ownership

Proprietary

Certified

Oct 1, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Kamaljot Bajwa

  • Psychiatric/Mental Health Nurse Practitioner
  • Modesto, CA
  • NPI 1659981330

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer

  CMS ownership

Practitioners 2

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.

• Frank Kelly, RN

  • Home Health Registered Nurse
  • Fresno, CA
  • NPI 1558871053

  Emergency

  NPD Authorized official
• Kamaljot Bajwa

  • Psychiatric/Mental Health Nurse Practitioner
  • Modesto, CA
  • NPI 1659981330
  NPD

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Stephanie D Hernandez, AGNP

  • Nurse Practitioner
  • Planada, CA
  • NPI 1003380452

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1275043770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 FULTON ST STE 714",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937212513",
            "telephone_number": "559-977-3952",
            "fax_number": "559-420-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 FULTON ST STE 714",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937212513",
            "telephone_number": "559-977-3952",
            "fax_number": "559-420-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE RIDGE HOME HEALTH NURSING CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "209-617-9625",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "789398",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "CA",
            "license": "789398",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "CA",
            "license": "789398",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275043770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite Ridge Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dianna Sydney Grandell, LVN
• Witney Kristine Grandi
• Grandvex Commerce LLC
• Richard Granese, M.D.
• Granite Reven LLC
• Adam Michael Grant, DDS
• Anna Marie Grant
• Craig Edward Grant
• Kimberly Gilliam Grant, PA-C
• Laura Dawn Grant

• Home Health Agency in Fresno, CA
• Providers in Fresno, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.