Active NPI
Grant Edward Stevens, HIS
- Hearing Instrument Specialist
- Port Charlotte, FL
National Provider Identifier
1407178486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- AS-4012
- Practice address
- 2866 Tamiami TRL Ste D
Port Charlotte, FL 33952 - Phone
- (941) 249-9142
- Fax
- (941) 377-0808
- NPI assigned
- Feb 18, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | AS-4012 | FL | Primary |
Addresses
Primary practice location
2866 Tamiami TRL Ste D
Port Charlotte, FL 33952
Mailing address
5969 Cattleridge Blvd Ste 100
Sarasota, FL 34232-6050
Phone (941) 249-9142
Other practice location 1
5969 Cattleridge Blvd Ste 100
Sarasota, FL 34232-6050
Phone (941) 249-9142
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AS-4012 | FL | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528761600000",
"number": "1407178486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5969 CATTLERIDGE BLVD STE 100",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342326050",
"telephone_number": "941-249-9142",
"fax_number": "941-377-0808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2866 TAMIAMI TRL STE D",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "33952",
"telephone_number": "941-249-9142",
"fax_number": "941-377-0808"
}
],
"practiceLocations": [
{
"address_1": "5969 Cattleridge Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "Sarasota",
"state": "FL",
"postal_code": "342326050",
"country_code": "US",
"telephone_number": "941-249-9142",
"fax_number": "941-377-0808",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEVENS",
"first_name": "GRANT",
"middle_name": "EDWARD",
"credential": "HIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-18",
"last_updated": "2018-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "FL",
"license": "AS-4012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.