Active NPI
Gregory Layne Grant, PA-C
- Physician Assistant
- Saint Albans, WV
National Provider Identifier
1336364942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- WV 871
- Practice address
- 610 Dames St
Saint Albans, WV 25177-2652 - Phone
- (304) 201-3150
- Fax
- (304) 201-3159
- NPI assigned
- Apr 17, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | WV 871 | WV | Primary |
Addresses
Primary practice location
610 Dames St
Saint Albans, WV 25177-2652
Mailing address
136 9TH Ave
Huntington, WV 25701-2708
Phone (304) 539-6214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WV 871 | WV | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336364942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 9TH AVE",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257012708",
"telephone_number": "304-539-6214",
"fax_number": "304-201-3159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 DAMES ST",
"city": "SAINT ALBANS",
"state": "WV",
"postal_code": "251772652",
"telephone_number": "304-201-3150",
"fax_number": "304-201-3159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "GREGORY",
"middle_name": "LAYNE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "WV 871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Albans, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.