Individual provider Active NPI

Joelene Grandy

  • Contractor
  • Virginia Beach, VA
National Provider Identifier
1336679349
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
1892 Riverrock Arch
Virginia Beach, VA 23456
Phone
(757) 471-2113
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

1892 Riverrock Arch
Virginia Beach, VA 23456

Mailing address

1892 River Rock Arch
Virginia Beach, VA 23456-6164

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

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1336679349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1892 RIVER ROCK ARCH",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234566164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1892 RIVERROCK ARCH",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23456",
            "telephone_number": "757-471-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDY",
        "first_name": "JOELENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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.