Gillian Grannum, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS018690 Issued in PA

Practice address

344 N Reading Rd
Ephrata, PA 17522-1651

Phone

(717) 738-1125

Fax

(717) 738-0606

NPI assigned

May 21, 2013

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

PhilhavenGroup PAC ID 8729991419, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Philhaven

  dba WellSpan Philhaven

  • Psychiatry Physician
  • Lebanon, PA
  • NPI 1043316441
  Medicare reassignment Care Compare group NPD
• Wellspan Medical Group

  dba WellSpan Digestive Health

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  Medicare reassignment NPD
• Philhaven

  dba WellSpan Philhaven

  • Psychiatric Hospital
  • Lebanon, PA
  • NPI 1972598076
  NPD
• Wellspan Medical Group

  dba Wellspan Internal Medicine - Apple Hill

  • Internal Medicine Physician
  • York, PA
  • NPI 1093883084
  NPD
• Wellspan Medical Group

  dba WellSpan Pediatric Surgical Specialist

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• Wellspan Medical Group

  dba Wellspan Readycare

  • Family Medicine Physician
  • York, PA
  • NPI 1598862716
  NPD (past)

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1407292162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 N READING RD",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221651",
            "telephone_number": "717-738-1125",
            "fax_number": "717-738-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Martin Ave",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221724",
            "country_code": "US",
            "telephone_number": "717-733-0311",
            "fax_number": "717-738-6735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANNUM",
        "first_name": "GILLIAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS018690",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103573403",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - PSYCHOLOGIST",
            "identifier": "PS018690",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "14373031",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine L Goldhammer, MD
• Good Samaritan Physician Services (WellSpan Medical Oncology and Hematology)
• Good Samaritan Services
• James Gorman, RN
• Nirutisai K Graff, MD
• Krista M Gray, CRNP
• Michael Joseph Greco, D.O
• Dennis Green, CRNA
• Gary Joe Greve, DC ACRB III
• Jonathan H Griner, MD

• Clinical Psychologist in Ephrata, PA
• Providers in Ephrata, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.