Individual provider Active NPI

Grant Bradford McConaughy, FNP-BC

  • Family Nurse Practitioner
  • Castle Rock, CO
National Provider Identifier
1417282351
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0996865-NP Issued in CO
Practice address
1832 Morningview LN
Castle Rock, CO 80109-3641
Phone
(303) 660-2568
NPI assigned
Oct 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 190972 CO
Family Nurse Practitioner 363LF0000X 4704383251 MI
Family Nurse Practitioner 363LF0000X APN.0996865-NP CO Primary

Addresses

Primary practice location

1832 Morningview LN
Castle Rock, CO 80109-3641

Mailing address

1832 Morningview LN
Castle Rock, CO 80109-3641
Phone (561) 797-8839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20220218001044 MI Practitioner - Nurse Practitioner 3971997800 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mount Pleasant, MI 48858-3257
Phone (989) 772-6811

2853 Health Pkwy
Mt Pleasant, MI 48858-9374
Phone (989) 779-5222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
190972COMDRegistered Nurse
APN.0996865-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reed City Hospital Corporation CurrentSince Jun 30, 2023 Accepting new patients
McLaren Central Michigan Current Accepting new patients
Reed City Hospital Corporation CurrentSince Jun 30, 2023 Accepting new patients
Mecosta County Medical Center Current Accepting new patients
McLaren Central Michigan CurrentSince Jul 10, 2023 Accepting new patients
McLaren Central Michigan CurrentSince Jul 10, 2023 Accepting new patients
Mecosta County Medical Center CurrentSince Jun 30, 2023 Accepting new patients
Mecosta County Medical Center Nurse Practitioner CurrentSince Jun 30, 2023 Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

14755 215th Ave
Big Rapids, MI 49307
Phone (231) 796-3200

1201 South Dr
Ste 341
Mt Pleasant, MI 48858
Phone (800) 523-1014

2853 Health Pkwy
Ste A
Mt Pleasant, MI 48858
Phone (989) 775-7641

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

300 N Patterson Rd
Reed City, MI 49677
Phone (231) 832-3271

Organizations & group practices 9

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1417282351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 MORNINGVIEW LN",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093641",
            "telephone_number": "561-797-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 MORNINGVIEW LN",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093641",
            "telephone_number": "303-660-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONAUGHY",
        "first_name": "GRANT",
        "middle_name": "BRADFORD",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-09",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "190972",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704383251",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0996865-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.