Individual provider Active NPI

William C Grall, LPN

  • Licensed Practical Nurse
  • Dousman, WI
National Provider Identifier
1609187442
Registry record updated Jun 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
14370031 Issued in WI
Practice address
231 Ridgeway Dr
Dousman, WI 53118-9346
Phone
(262) 719-7408
NPI assigned
Jun 26, 2010
Last updated
Jun 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 14370031 WI Primary

Addresses

Primary practice location

231 Ridgeway Dr
Dousman, WI 53118-9346

Mailing address

231 Ridgeway Dr
Dousman, WI 53118-9346
Phone (262) 719-7408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14370031WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1277510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277510400000",
    "number": "1609187442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 RIDGEWAY DR",
            "city": "DOUSMAN",
            "state": "WI",
            "postal_code": "531189346",
            "telephone_number": "262-719-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 RIDGEWAY DR",
            "city": "DOUSMAN",
            "state": "WI",
            "postal_code": "531189346",
            "telephone_number": "262-719-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRALL",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-26",
        "last_updated": "2010-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "14370031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dousman, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2010; 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.