Individual provider Active NPI

Abbot Lee Granoff, MD

  • Specialist
  • Norfolk, VA
National Provider Identifier
1619018637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101028334 Issued in VA
Practice address
6330 Newtown Rd
Suite 316
Norfolk, VA 23502-4802
Phone
(757) 461-7571
Fax
(757) 455-5550
NPI assigned
Feb 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101028334 VA Primary

Addresses

Primary practice location

6330 Newtown Rd
Suite 316
Norfolk, VA 23502-4802

Mailing address

6330 Newtown Rd
Suite 316
Norfolk, VA 23502-4802
Phone (757) 461-7571

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101028334VAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619018637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 NEWTOWN RD",
            "address_2": "SUITE 316",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024802",
            "telephone_number": "757-461-7571",
            "fax_number": "757-455-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 NEWTOWN RD",
            "address_2": "SUITE 316",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024802",
            "telephone_number": "757-461-7571",
            "fax_number": "757-455-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANOFF",
        "first_name": "ABBOT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101028334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.