NPIMap

Individual provider Active NPI

Deidrea Latrice Grandberry, MD

  • Obstetrics Physician
  • Memphis, TN
National Provider Identifier
1588715254
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
MD38629 Issued in TN
Practice address
7705 Poplar Ave
Ste 150 BLDG B
Memphis, TN 38138-3930
Phone
(901) 276-3222
Fax
(901) 276-1398
NPI assigned
Jan 16, 2007
Last updated
Nov 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X MD38629 TN Primary

Addresses

Primary practice location

7705 Poplar Ave
Ste 150 BLDG B
Memphis, TN 38138-3930

Mailing address

1469 Poplar Ave
Memphis, TN 38104-2934
Phone (901) 276-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050526001029 TN Practitioner - Obstetrics/Gynecology 9830131093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Tennessee, HSC, College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memphis Obstetrics and Gynecological Association PCGroup PAC ID 7214918762, 46 clinicians

Practice addresses (Care Compare)

681 S White Station Rd
Suite 111
Memphis, TN 38117-4563
Phone (901) 276-3222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.6 of 100Reported as group
Quality
92.14
Promoting interoperability
100
Improvement activities
40
Cost
76.54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD38629TNMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Obstetrics and Gynecological Association PC CurrentSince Jan 1, 2015 Accepting new patients
Womens Health Specialists, PLLC Current Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Baptist Memorial Hospital Past Accepting new patients

Locations

1469 Poplar Ave
Memphis, TN 38104
Phone (901) 273-1190

6215 Humphreys Blvd
Ste 401
Memphis, TN 38120
Phone (901) 682-9222

681 S White Station Rd
Ste 111
Memphis, TN 38117
Phone (901) 276-3222

Interoperability endpoints

  • Direct secure messaging: deidrea.grandberry.1@16415.direct.athenahealth.com
  • Direct secure messaging: dgrandberry25086@mlh.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/16415/brand/2/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1588715254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1469 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042934",
            "telephone_number": "901-276-3222",
            "fax_number": "901-276-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7705 POPLAR AVE",
            "address_2": "STE 150 BLDG B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381383930",
            "telephone_number": "901-276-3222",
            "fax_number": "901-276-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDBERRY",
        "first_name": "DEIDREA",
        "middle_name": "LATRICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "TN",
            "license": "MD38629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.