Casey Granger, DNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Jber, AK
NPI 1295517019 · NPPES record last updated Oct 17, 2023
Key facts
- NPI
- 1295517019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 211546 (AK)
- Practice address
- 8415 Metzger Ave Unit a
Jber, AK 99506-2025 - Phone
- (402) 926-8352
- NPI assigned
- Oct 17, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240221004341 | AK | Practitioner - Nurse Practitioner | 8820432446 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Current |
Accepting new patients | |
| Providence Health & Services - Washington | Current |
Accepting new patients |
Locations
3760 Piper St
Ste 1108A
Anchorage, AK 99508
Phone (907) 212-6900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 211546 | AK | Yes |
Addresses
Primary practice location
8415 Metzger Ave Unit a
Jber, AK 99506-2025
Mailing address
8415 Metzger Ave Unit a
Jber, AK 99506-2025
Phone (402) 926-8352
Other providers in Jber, AK
- Melissa Godines
- Phillip John Goebel
- Rachelle Goebel
- Ciera Good
- Angela C Gookin
- Elaine Marie Grant
- Nathan Greene
- Ryan Reynolds Haas
- Jeffrey R Hall
- Wilma Deanne Harpole
All providers in Jber, AK · Psychiatric/Mental Health Nurse Practitioner in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.