Individual provider Active NPI

William J Granger, MD

  • Anesthesiology Physician
  • Lafayette, IN
National Provider Identifier
1619960671
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01033203A Issued in IN
Practice address
5165 McCarty LN
Lafayette, IN 47905-8764
Phone
(765) 448-8000
Fax
(765) 446-4695
NPI assigned
Aug 25, 2005
Last updated
Oct 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01033203 IN
Anesthesiology Physician 207L00000X 01033203A IN Primary

Addresses

Primary practice location

5165 McCarty LN
Lafayette, IN 47905-8764

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

441 N Wabash Ave
Marion, IN 46952-2612
Phone (765) 662-3320

Other identifiers 1

IdentifierTypeStateIssuer
100106810MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wgranger@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01033203INMDAnesthesiology Physician
01033203AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Arnett Clinic, LLC Anesthesiology CurrentSince Oct 17, 2022 Accepting new patients
Sda Consultants PLLC Anesthesiology CurrentSince May 1, 2022 Accepting new patients
Ams Northern Indiana LLC Anesthesiology CurrentSince Feb 1, 2020 Accepting new patients
United Surgeons, LLC Current Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients
Arnett Clinic, LLC CurrentSince Oct 17, 2022 Accepting new patients
Great Lakes Anesthesia, P.C. Anesthesiology CurrentSince Oct 15, 2017 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

1004 Parkway Ave
Ste A
Elkhart, IN 46516
Phone (800) 966-7841

500 Arcade Ave
Ste 100
Elkhart, IN 46514
Phone (574) 389-5683

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

2600 Greenbush St
Lafayette, IN 47904

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

5165 McCarty Ln
Rm 28A
Lafayette, IN 47905

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

3930 Edison Lakes Pkwy
Ste 100
Mishawaka, IN 46545

4455 Edison Lakes Pkwy
Mishawaka, IN 46545
Phone (574) 231-6134

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181

Interoperability endpoints

  • Direct secure messaging: wgranger@direct.iuhealth.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1619960671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5165 MCCARTY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479058764",
            "telephone_number": "765-448-8000",
            "fax_number": "765-446-4695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 N Wabash Ave",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IN",
            "postal_code": "469522612",
            "country_code": "US",
            "telephone_number": "765-662-3320",
            "fax_number": "765-662-3368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01033203",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01033203A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106810",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wgranger@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5165 McCarty Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479058764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.