Grange Surgery Center PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GRANGE SURGERY CENTER PLLC

Practice address

450 W State St Ste 250
Eagle, ID 83616-6974

Phone

(208) 506-7966

NPI assigned

Oct 14, 2022

Last updated

Aug 22, 2023By 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

Landon Grange, MD

Title

Medical Director

Phone

(208) 506-7966

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1316663032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 250",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166974",
            "telephone_number": "208-506-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 250",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166974",
            "telephone_number": "208-506-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANGE SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "GRANGE",
        "authorized_official_first_name": "LANDON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "208-506-7966",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Hour Acupuncture & Wellness
• Hannah Wenle Gottenberg, LPC
• Nicholas Grable, DC
• Sarah Jo Graham, MPT
• Grange Ophthalmology, PLLC (Grange Eye Care)
• Alan James Gray, MD
• Katie Gray, M.S.
• Sariah Gray
• Alexandria Cavaretta Green, APRN-CNP
• Kari Green, PT

• Ambulatory Surgical Clinic/Center in Eagle, ID
• Providers in Eagle, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.