Individual provider Active NPI

Wannie D Mark-Grant, FNP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1427352871
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003512A Issued in IN
Practice address
10473 Day Star Dr
Indianapolis, IN 46234-7675
Phone
(317) 345-4242
NPI assigned
Dec 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71003512A IN Primary

Addresses

Primary practice location

10473 Day Star Dr
Indianapolis, IN 46234-7675

Mailing address

10473 Day Star Dr
Indianapolis, IN 46234-7675
Phone (317) 345-4242

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1427352871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10473 DAY STAR DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462347675",
            "telephone_number": "317-345-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10473 DAY STAR DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462347675",
            "telephone_number": "317-345-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK-GRANT",
        "first_name": "WANNIE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003512A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.