Grandy Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GRANDY FAMILY MEDICINE PC

Practice address

7429 Caratoke Hwy
Jarvisburg, NC 27947-9708

Phone

(252) 491-2111

Fax

(833) 689-6830

NPI assigned

Nov 21, 2018

Organization subpart

No

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

Authorized official

Name

Leslie M McPherson, MD

Title

Owner

Phone

(252) 491-2111

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Nicole Crocker, FNP-C

  • Family Nurse Practitioner
  • Jarvisburg, NC
  • NPI 1871267211
  NPD
• Kiera Elise Clark, NP

  • Family Nurse Practitioner
  • Shiloh, NC
  • NPI 1699369645

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1609345412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211",
            "city": "JARVISBURG",
            "state": "NC",
            "postal_code": "279470211",
            "telephone_number": "252-491-2111",
            "fax_number": "833-689-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7429 CARATOKE HWY",
            "city": "JARVISBURG",
            "state": "NC",
            "postal_code": "279479708",
            "telephone_number": "252-491-2111",
            "fax_number": "833-689-6830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4692 Brownsboro Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063410",
            "country_code": "US",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRANDY FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "MCPHERSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-491-2111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Taylor Cohen
• Lauren Nicole Crocker, FNP-C
• Gaston Family Health Services, Inc.
• Madeline Kiousis
• Mane & Taill Therapeutic Horsemanship Academy
• Stacie M Medlin, LCSW
• James Lee Owens, MD
• Jessica Penson-Heyder, LCSW

• Family Medicine Physician in Jarvisburg, NC
• Providers in Jarvisburg, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.