Charla Gayle Granberry, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

246073 Issued in TX

Practice address

1005 W Ralph Hall Pkwy
Rockwall, TX 75032-6658

Phone

(972) 771-9081

Fax

(972) 772-7102

NPI assigned

Feb 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• R. Greg Maul, D.O., P.a.

  • Family Medicine Physician
  • Lavon, TX
  • NPI 1982847596
  NPD (past)

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

• Lake Pointe Operating Company, LLC

  • General Acute Care Hospital
  • Rowlett, TX
  • NPI 1205018439
  Care Compare affiliation

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1457486193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 W RALPH HALL PKWY",
            "address_2": "SUITE 201",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326658",
            "telephone_number": "972-771-9081",
            "fax_number": "972-772-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W RALPH HALL PKWY",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326658",
            "telephone_number": "972-771-9081",
            "fax_number": "972-772-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANBERRY",
        "first_name": "CHARLA",
        "middle_name": "GAYLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "246073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTIONER",
            "identifier": "246073",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgranberry257440@direct.sw.org",
            "affiliation": "N",
            "address_1": "763 E. Highway 80",
            "address_2": "Suite 240",
            "city": "Forney",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Colleen Patricia Goodroe, PA-C
• Bridget Gordon
• Kara Diane Goss
• Patricia E Gossett, LPC
• Heather Graham, LPC
• Jaimee Granberry, LPC
• Emily Grant
• Lynn Grant
• Roman Grant, DDS
• Jessica Lynn Gray, P.T.

• Nurse Practitioner in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.