Janet Gradolph, CRNA

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4704089263 Issued in MI

Practice address

30200 Telegraph Rd
Suite 220
Bingham Farms, MI 48025-4502

Phone

(248) 258-5058

NPI assigned

Apr 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eastside Group LLC

  • Anesthesiology Physician
  • Saint Clair Shores, MI
  • NPI 1235365289
  NPD (past)
• Straith Hospital for Special Surgery

  • General Acute Care Hospital
  • Southfield, MI
  • NPI 1710037221
  NPD (past)
• Northstar Anesthesia of Michigan II PC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1437268026
  NPD (past)

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1619933272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 COVINGTON RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483012364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30200 TELEGRAPH RD",
            "address_2": "SUITE 220",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254502",
            "telephone_number": "248-258-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADOLPH",
        "first_name": "JANET",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-24",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4704089263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104670688",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Catherine Gorka, MS
• Susan Raznik Gormezano, OD
• Hari A Goro
• Jewel Andrea Gorospe
• William Edward Grace
• Andrea Jean Graham
• Brooke L Graham
• Jalen Alexander Graham
• Martina Graham
• Sherita Denise Grant

• Anesthesiology Physician in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.