Individual provider Active NPI

Granville Giltz Croley II, MD

  • Surgery Physician
  • Concord, NC
National Provider Identifier
1427011501
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35307 Issued in NC
Practice address
200 Medical Park Dr
Ste 430
Concord, NC 28025-2982
Phone
(704) 403-7070
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35307 NC Primary

Addresses

Primary practice location

200 Medical Park Dr
Ste 430
Concord, NC 28025-2982

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gcroley136801@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080304000516 NC Practitioner - General PracticePractitioner - Vascular Surgery 4486688686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 1, 2016 Accepting new patients
Carolinas Physicians Network Inc Surgery CurrentSince May 1, 2016 Accepting new patients
Piedmont Surgical Clinic, P.a. Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

200 Medical Park Dr
Ste 430
Concord, NC 28025
Phone (704) 403-5890

431 Copperfield Blvd NE
Concord, NC 28025
Phone (704) 403-7070

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/901579
  • Direct secure messaging: gcroley136801@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1427011501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "STE 430",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252982",
            "telephone_number": "704-403-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROLEY",
        "first_name": "GRANVILLE",
        "middle_name": "GILTZ",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "35307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gcroley136801@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "200 Medical Park Dr",
            "address_2": "Ste 430",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.