Individual provider Active NPI

Grant M Yager, MD

  • Student in an Organized Health Care Education/Training Program
  • Fort Wayne, IN
National Provider Identifier
1396555348
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2601 E Gump Rd
Fort Wayne, IN 46845-9740
Phone
(260) 450-1507
NPI assigned
Jan 11, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IN Primary

Addresses

Primary practice location

2601 E Gump Rd
Fort Wayne, IN 46845-9740

Mailing address

2601 E Gump Rd
Fort Wayne, IN 46845-9740
Phone (260) 450-1507

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1736553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1396555348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E GUMP RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459740",
            "telephone_number": "260-450-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E GUMP RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459740",
            "telephone_number": "260-450-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGER",
        "first_name": "GRANT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-11",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.