Roy N Grantham, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

16465 Issued in OK

Practice address

4221 S Western Ave
2010
Oklahoma City, OK 73109-3447

Phone

(405) 231-0540

Fax

(405) 644-5309

NPI assigned

Sep 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1568457265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 NW 58TH ST",
            "address_2": "450",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124726",
            "telephone_number": "405-951-4360",
            "fax_number": "866-857-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 S WESTERN AVE",
            "address_2": "2010",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093447",
            "telephone_number": "405-231-0540",
            "fax_number": "405-644-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "ROY",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OK",
            "license": "16465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5765290",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060052653",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100122170A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "125309100",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sylvester Grant Jr.
• Sylvina Grant
• Treyon L Grant, DDS
• Margaret Sue Grantham-Anderson, LPC
• Hillary Beth Grantham, M.A., LPC
• Ryan James Grantham, MD
• Luci Ann Gratch, ARNP
• Renee H Grau, MD
• Kristen Elizabeth Grauer, CPM
• Gravel Road Mental Health Services, PLLC

• Vascular Surgery Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Vascular Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.