NPIMap

Organization Active NPI

Vivian Nell Hannon

Doing business as Grant Family Practice Clinic

  • Family Medicine Physician
  • Guntersville, AL
National Provider Identifier
1316344906
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VIVIAN NELL HANNON
Doing business as
Grant Family Practice Clinic
Practice address
1241 Blount Ave
Guntersville, AL 35976-1831
Phone
(256) 582-6377
Fax
(256) 582-6376
NPI assigned
Nov 25, 2014
Last updated
Nov 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Authorized official

Name
Mrs. Vivian Nell Hannon, CRNPNPI 1346220191
Title
Owner/CRNP
Phone
(256) 582-6377

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AL Primary

Addresses

Primary practice location

1241 Blount Ave
Guntersville, AL 35976-1831

Mailing address

5447 Main Street
Grant, AL 35747-6211
Phone (256) 728-2272

Other names 1

  • Grant Family Practice Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041110001067 AL Part B Supplier - Clinic/Group Practice 6002879913 Receives reassigned benefits from 7 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Guntersville, AL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5447 Main St
Grant, AL 35747
Phone (256) 728-2272

1241 Blount Ave
Guntersville, AL 35976
Phone (256) 582-6377

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1316344906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5447 MAIN STREET",
            "city": "GRANT",
            "state": "AL",
            "postal_code": "357476211",
            "telephone_number": "256-728-2272",
            "fax_number": "256-728-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 BLOUNT AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359761831",
            "telephone_number": "256-582-6377",
            "fax_number": "256-582-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIAN NELL HANNON",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "HANNON",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "NELL",
        "authorized_official_title_or_position": "OWNER/CRNP",
        "authorized_official_telephone_number": "256-582-6377",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant Family Practice Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guntersville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.