Allyson M Granden, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2018038914 Issued in MO

Practice address

12266 Depaul Drive
Suite 205
Saint Louis, MO 63044-2727

Phone

(314) 218-2300

Fax

(314) 646-1700

NPI assigned

Feb 8, 2019

Sex

Female

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 2

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: amersman2183@direct-ehr-ssmhc.com

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1649735176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DEPAUL DRIVE",
            "address_2": "SUITE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "630442727",
            "telephone_number": "314-218-2300",
            "fax_number": "314-646-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDEN",
        "first_name": "ALLYSON",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2018038914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amersman2183@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "amersman2183@direct-ehr-ssmhc.com",
            "address_1": "12266 DePaul Drive",
            "address_2": "Suite 205",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "12266 DePaul Drive",
            "address_2": "Suite 205",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grand Manor Health Care Center, L.L.C.
• Grand Manor Nursing & Rehabilitation Center, L.L.C.
• Grand Manor SNF Opco LLC
• Grand Medical Group LLC
• Mark Gilbert Grand, MD
• Laura Granderson
• Grandmom Honey LLC
• Thomas M Graney, PA
• Dorothy K Grange, MD
• Laura Kathryn Granger Howard, MD

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.