Jon Barkley Grady, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

102852 Issued in NC

Practice address

262 Leroy George Dr
Suite M
Clyde, NC 28721-7430

Phone

(828) 452-8378

Fax

(828) 452-8326

NPI assigned

Dec 22, 2005

Last updated

Oct 24, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DLP Western Carolina Physician Practices LLC

  • Internal Medicine Physician
  • Sylva, NC
  • NPI 1609281641

  Physician Assistant

  Medicare reassignment NPD
• DLP Western Carolina Physician Practices LLC

  • Diagnostic Radiology Physician
  • Clyde, NC
  • NPI 1932925062
  NPD

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1346227105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 LEROY GEORGE DR",
            "address_2": "SUITE M",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287217430",
            "telephone_number": "828-452-8378",
            "fax_number": "828-452-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 LEROY GEORGE DR",
            "address_2": "SUITE M",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287217430",
            "telephone_number": "828-452-8378",
            "fax_number": "828-452-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "JON",
        "middle_name": "BARKLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "102852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Najeeb Omar Ghaussy, MD
• Aaron James Giese, P.A.
• Mary Elizabeth Goforth, DPT
• Amber Reece Golden, RN
• Steven Marshall Gore, MEDICAL DOCTOR MD
• Charles M Gross, M.D.
• Jay Weston Grosse, M.D.
• Kristin C. Gruner, PA
• James Daniel Guerriere Jr., M.D.
• Tiffany Jenann Hallmark

• Medical Physician Assistant in Clyde, NC
• Providers in Clyde, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.