Stacy Ann Granner, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

31931 Issued in IA

Practice address

1360 N Dodge St
Iowa City, IA 52245-6104

Phone

(319) 351-1448

Fax

(319) 351-9367

NPI assigned

Jul 15, 2006

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 names 1

• Stacy Ann Tschannen Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• State University of Iowa

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814

  Pediatrics

  Medicare reassignment NPD
• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  NPD (past)
• State University of Iowa

  • Student Health Clinic/Center
  • Iowa City, IA
  • NPI 1285635664
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1487670840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-351-1448",
            "fax_number": "319-351-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 N DODGE ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522456104",
            "telephone_number": "319-351-1448",
            "fax_number": "319-351-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANNER",
        "first_name": "STACY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "31931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "TSCHANNEN",
            "middle_name": "ANN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Martin Grana Basurco, MD
• Thomas S. Granchi, MD
• Victoria Elnora Grandinetti, ARNP
• Nataliya Grandt, APRN
• Mark A Granner, MD
• Lorna Grant, M.D.
• Michael Ting Grassi, MD
• Justin Grassmeyer, MD
• Abigail Carol Grathwohl, DO
• David G Gratton, DDS

• Pediatrics Physician in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.