Individual provider Active NPI

Mary Meaghan Granger, MD

  • Pediatric Hematology & Oncology Physician
  • Memphis, TN
National Provider Identifier
1558473017
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
31299 Issued in TN
Practice address
262 Danny Thomas PL
Memphis, TN 38105-3678
Phone
(901) 595-3300
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X L1870 TX
Pediatric Hematology & Oncology Physician 2080P0207X L1870 TX
Pediatric Hematology & Oncology Physician 2080P0207X 31299 TN Primary

Addresses

Primary practice location

262 Danny Thomas PL
Memphis, TN 38105-3678

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Other practice location 1

1500 Cooper St
Fort Worth, TX 76104-2710
Phone (682) 885-4007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091214000234 TX Practitioner - Pediatric MedicinePractitioner - Hematology/OncologyPractitioner - Hematopoietic Cell Transplantation and Cellular Therapy 6507906179 Reassigns benefits to 1 organization
I20241007003428 TN Practitioner - Pediatric Medicine 6507906179 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network CurrentSince Jul 19, 2012 Accepting new patients
St Jude Children's Research Hospital, Inc. Pediatric Hematology-Oncology CurrentSince Jul 8, 2024 Accepting new patients
Cook Children's Physician Network CurrentSince Jul 19, 2012 Accepting new patients

Locations

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 595-3006

1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1558473017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-595-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Cooper St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761042710",
            "country_code": "US",
            "telephone_number": "682-885-4007",
            "fax_number": "682-885-3914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "MARY",
        "middle_name": "MEAGHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "L1870",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "L1870",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TN",
            "license": "31299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.