Grant Evan Cettie, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1092 Issued in TX

Practice address

2921 Southwest Pkwy
Wichita Falls, TX 76308-4121

Phone

(940) 692-7078

Fax

(940) 692-7079

NPI assigned

Aug 3, 2006

Last updated

Jul 22, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1356359624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 SOUTHWEST PKWY",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763084121",
            "telephone_number": "940-692-7078",
            "fax_number": "940-692-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 SOUTHWEST PKWY",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763084121",
            "telephone_number": "940-692-7078",
            "fax_number": "940-692-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CETTIE",
        "first_name": "GRANT",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1536252-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8B5600",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Cavazos, SLP
• Glenn Lee Cavett, D.C.
• Cedar Crest Clinic
• Ayres R Cermin
• Cesar H Porta MD PLLC
• Amanda Jo Chaboya, RN
• Satish Chada, M.D.
• Chandramouli Chakinala, M.D.
• Kiran Kumar Challagali, MD
• Jagathi Devi Challagalla, M.D.

• Foot & Ankle Surgery Podiatrist in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.