David Bryant Grantham, ED.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC0000001693 Issued in TN

Practice address

296 Gamble Ave
Maryville, TN 37801-4943

Phone

(865) 980-6464

Fax

(865) 977-6823

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1548200322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 GAMBLE AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014943",
            "telephone_number": "865-980-6464",
            "fax_number": "865-977-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 GAMBLE AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014943",
            "telephone_number": "865-980-6464",
            "fax_number": "865-977-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "DAVID",
        "middle_name": "BRYANT",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "LPC0000001693",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "LMT0000000581",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "431961623",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "015174",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Layla Grant Moore
• Gabriel Gordon Gravatt, PTA
• Mary Kathleen Gravatt, PTA
• Sherri Graves, M.A., CCC-SLP
• Rebecca W Gray, CCC-SLP
• Robyn Rarick Gray, NP

• Professional Counselor in Maryville, TN
• Providers in Maryville, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.