Jacob Carlos Earl Grant, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

01095875A Issued in IN

Practice address

510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016

Phone

(314) 362-7200

Fax

(314) 747-4189

NPI assigned

Mar 25, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, IN2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Indiana University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Decatur County Memorial HospitalGroup PAC ID 7315837671, 128 clinicians

Radiology of Indiana P CGroup PAC ID 0648161430, 122 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
• Community Hospital East Hospital, Indianapolis, IN, CCN 150074
• Community Howard Regional Health Inc. Hospital, Kokomo, IN, CCN 150007
• Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128
• Community Hospital North Hospital, Indianapolis, IN, CCN 150169

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Decatur County Memorial Hospital

  • Critical Access Hospital
  • Greensburg, IN
  • NPI 1952300477
  Medicare reassignment Care Compare group NPD
• Radiology of Indiana P C

  • Diagnostic Radiology Physician
  • Indianapolis, IN
  • NPI 1992723829
  Medicare reassignment Care Compare group NPD
• Miracl, LLC

  • Multi-Specialty Clinic/Center
  • Rolla, MO
  • NPI 1205304300
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475

  Diagnostic Radiology

  Medicare reassignment NPD
• Decatur County Memorial Hospital

  • Rural Health Clinic/Center
  • Greensburg, IN
  • NPI 1437900800
  NPD
• Decatur County Memorial Hospital

  • General Practice Physician
  • Greensburg, IN
  • NPI 1619193505
  NPD

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

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Care Compare affiliation
• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1619163854
  Care Compare affiliation
• Community Hospital South, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1235109778
  Care Compare affiliation
• Community Howard Regional Health, Inc

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1902878994
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1376214981
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1386749893
  Care Compare affiliation

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1639639669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9998 CROSSPOINT BLVD STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563307",
            "telephone_number": "317-579-2150",
            "fax_number": "317-806-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "address_2": "DEPT RADIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JACOB",
        "middle_name": "CARLOS EARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01095875A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittany Grant
• Conor Grant
• Cori L Grant, MD
• Darvella Grant
• Ericka Elizabeth Grant, MA
• Justice Dashay Grant
• Kenya Grant
• Lauren Anne Grant, MD
• Amanda Grapperhaus, PHARMD
• Marybeth Gras, LCSW

• Diagnostic Radiology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.