Grady Podiatry LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36003597 Issued in OH

Legal business name

GRADY PODIATRY LLC

Practice address

1502 Lear Industrial Pkwy
1A
Avon, OH 44011-1379

Phone

(440) 937-5400

Fax

(440) 937-5533

NPI assigned

May 19, 2014

Organization subpart

No

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

Authorized official

Name

Jack R Grady, DPM

Title

DPM

Phone

(440) 937-5400

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela Fenell Grady, D.P.M

  • Podiatrist
  • Fairview Park, OH
  • NPI 1992930135
  NPD (past)

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1508277963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20800 WESTGATE MALL",
            "address_2": "401",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261323",
            "telephone_number": "440-333-7722",
            "fax_number": "440-356-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 LEAR INDUSTRIAL PKWY",
            "address_2": "1A",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111379",
            "telephone_number": "440-937-5400",
            "fax_number": "440-937-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "GRADY",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "440-937-5400",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Donna Goodwin, APRN, CNP
• Irene Chryssovalantou Grabovac, NP
• Kristina Grasso, PT, DPT
• Great Lakes Podiatry Center Inc
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• Paul Joseph Griesacker, PHARM D
• Guadalupe Home

• Podiatrist in Avon, OH
• Providers in Avon, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.