Individual provider Active NPI

David Christian Grant, MD

  • General Practice Physician
  • Marquette, MI
National Provider Identifier
1639261035
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301089202 Issued in MI
Practice address
420 W Magnetic St
Marquette, MI 49855-2711
Phone
(906) 225-3561
NPI assigned
Sep 30, 2006
Last updated
Apr 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD25662 OR
General Practice Physician 208D00000X 4301089202 MI Primary

Addresses

Primary practice location

420 W Magnetic St
Marquette, MI 49855-2711

Mailing address

4602 Dept
Carol Stream, IL 60122-0021
Phone (906) 225-4821

Other identifiers 3

IdentifierTypeStateIssuer
5212533MedicaidMI
DG089202OtherMIBLUE CROSS
P00456632OtherMIRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000212 MI Practitioner - Emergency Medicine 2163323908 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oregon Health Sciences University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3401 Ludington St
Escanaba, MI 49829-1300
Phone (906) 786-5707

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25662ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
Baraga County Memorial Hospital Emergency Medicine CurrentSince Aug 2, 2017 Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Marquette Medical PLLC Emergency Medicine CurrentSince Feb 5, 2024 Accepting new patients
Baraga County Memorial Hospital CurrentSince Aug 2, 2017 Accepting new patients
Marquette Medical Mindful Wellness PastSince Feb 5, 2024 Accepting new patients

Locations

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

18341 US Highway 41
Lanse, MI 49946
Phone (906) 524-3300

1025 W Washington St
Ste A
Marquette, MI 49855
Phone (906) 239-5050

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

2833 US Highway 41 W
Marquette, MI 49855

420 W Magnetic St
Marquette, MI 49855
Phone (906) 225-3540

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1639261035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 DEPT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601220021",
            "telephone_number": "906-225-4821",
            "fax_number": "906-225-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552711",
            "telephone_number": "906-225-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "DAVID",
        "middle_name": "CHRISTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD25662",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301089202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5212533",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "DG089202",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00456632",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.