Suzanne Hicks Grantham, PMHNP APRN BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

720359 Issued in TX

Practice address

1101 S Capital of Texas Hwy
BLDG a Suite 200
Austin, TX 78746

Phone

(523) 617-6746

Fax

(512) 329-5522

NPI assigned

Nov 9, 2005

Last updated

May 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2013 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Lifecare Family Services

  • Community/Behavioral Health Agency
  • Pulaski, TN
  • NPI 1245484005
  NPD (past)
• Omni Community Health

  • Social Worker
  • Nashville, TN
  • NPI 1437125416
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1427039098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S CAPITAL OF TEXAS HWY",
            "address_2": "BLDG A SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787466400",
            "telephone_number": "512-617-6746",
            "fax_number": "512-329-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S CAPITAL OF TEXAS HWY",
            "address_2": "BLDG A SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78746",
            "telephone_number": "523-617-6746",
            "fax_number": "512-329-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "SUZANNE",
        "middle_name": "HICKS",
        "name_prefix": "Mrs.",
        "credential": "PMHNP APRN BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "720359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Grant, M.A.
• Mae Marie Grant, LPC, NCC
• Richard Dominic Grant Jr., PH.D.
• Zachary Ty Grant, D.C.
• Jennifer Ann Grantham, CCC-SLP
• Troy W. Gras, M.D.
• Rachel Grassity
• Patrick John Grathwohl Jr., M.D.
• Katherine Grau, LCSW
• Alyse Nicole Graul

• Psychiatric/Mental Health Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.