Robert Grandinetti, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

010300936 Issued in VA

Practice address

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952

Phone

(703) 934-5909

Fax

(703) 934-5788

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1336290394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 EAST JEFFERSON STREET",
            "address_2": "KAISER PERMANENTE, PPQA, 6 WEST, ATTN: THERESA BROOKS",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-816-6660",
            "fax_number": "301-816-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 FAIR LAKES PKWY",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333952",
            "telephone_number": "703-934-5909",
            "fax_number": "703-934-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDINETTI",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "010300936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "12255 Fair Lakes Pkwy",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220333952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Gragan
• Ruth Elizabeth Graham
• Sacha J Graham, LMHP-S, MSW, QMHCM
• Joy Lorraine Granados, LCSW
• Gail Leslie Grandela, LPC, CCM
• Caitlin Grant
• Ethan Grant
• Kelley Dianne Grant, LPTA
• Sydney Grant, RN
• Vittoria Grant, LPC

• Podiatrist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.