Granger Retina Center PC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

GRANGER RETINA CENTER PC

Practice address

2288 Banyan Hill CT
Fort Wayne, IN 46814-9590

Phone

(225) 573-9954

NPI assigned

Aug 19, 2026

Last updated

Aug 19, 2026By 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

Dr. Jason Min So, MD

Title

President

Phone

(225) 573-9954

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1346155611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2288 BANYAN HILL CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 BANYAN HILL CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149590",
            "telephone_number": "225-573-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANGER RETINA CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "SO",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-573-9954",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa D Graham
• Mikayla Graham
• Rebecca Marie Graham, PTA
• April Granchelle
• Benjamin Joseph Grandy, D.O.
• Kelly Lee Grant, OTR
• Marcia K Grant, LCSW LMFT
• Mary M Grant, SLP
• Molly Marie Grasberger, PHARMD
• Kayleen M Grashoff, NP

• Retina Specialist (Ophthalmology) Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Retina Specialist (Ophthalmology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.