Grant Thomas Land, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

004108 Issued in GA

Practice address

1445 Old McDonough Hwy SE, Suite E
Conyers, GA 30094-7788

Phone

(770) 922-9222

Fax

(770) 504-6318

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Qcpi-Villagemd, PC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432
  Medicare reassignment
• Jameson a Estes, MD, PC

  • Family Medicine Physician
  • Monticello, GA
  • NPI 1619319027
  NPD
• Medical Centre of Conyers

  • Clinic/Center
  • Conyers, GA
  • NPI 1710946371
  NPD
• Shannon T. Barton MD LLC

  • Family Medicine Physician
  • Monticello, GA
  • NPI 1811293137
  NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168

  Family Medicine

  NPD (past)
• Newton County Medical Associates, PC

  • Internal Medicine Physician
  • Covington, GA
  • NPI 1386660918
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1508816570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6175 NEWTON DR NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142690",
            "telephone_number": "770-787-6900",
            "fax_number": "770-787-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 OLD MCDONOUGH HWY SE, SUITE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300947788",
            "telephone_number": "770-922-9222",
            "fax_number": "770-504-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "GRANT",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "004108",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003200095A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE NUMBER",
            "identifier": "004108",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela M Lake, LPC
• Jai Parkash Lal
• Hushen Habibbhai Lalani, M.D.
• Ashley Lamar
• Kathleen E Lambert, MD
• Evelyn Lane
• Micah Lane
• Nancy Larrow, CMA
• Lascala Chiropractic, P.C.
• Laurus Surgical, L.L.C

• Medical Physician Assistant in Conyers, GA
• Providers in Conyers, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.