Active NPI
David J Grayson, M.D.
- Family Medicine Physician
- Sandusky, OH
National Provider Identifier
1467410076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35049350G
- Practice address
- 5420 Milan Rd
Firelands Corporate Health
Sandusky, OH 44870-5846 - Phone
- (419) 557-5052
- Fax
- (419) 624-0513
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35049350G | OH | Primary |
Addresses
Primary practice location
5420 Milan Rd
Firelands Corporate Health
Sandusky, OH 44870-5846
Mailing address
5420 Milan Rd
Sandusky, OH 44870-5846
Phone (419) 557-5052
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0575499 | Medicaid | OH |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35049350G | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emh Professional Services Inc. | Family Medicine | Past | Accepting new patients |
| Samaritan Emergency Physicians LLP | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1467410076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5420 MILAN RD",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448705846",
"telephone_number": "419-557-5052",
"fax_number": "419-624-0513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5420 MILAN RD",
"address_2": "FIRELANDS CORPORATE HEALTH",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448705846",
"telephone_number": "419-557-5052",
"fax_number": "419-624-0513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAYSON",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35049350G",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0575499",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandusky, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.