Rebecca Grandy, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A03707 Issued in AR

Practice address

4720 Dollarway Rd
Pine Bluff, AR 71602-4126

Phone

(870) 536-3279

Fax

(870) 536-3283

NPI assigned

Jun 13, 2012

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

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Team of Arkansas Physicians LLCGroup PAC ID 1850539198, 155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Urgent Team of Arkansas Physicians, LLC

  • Rural Health Clinic/Center
  • Searcy, AR
  • NPI 1992041370
  Medicare reassignment Care Compare group
• Jefferson Hospital Association, Inc

  • Pulmonary Disease Physician
  • Pine Bluff, AR
  • NPI 1932157674
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  AR

  Medicare reassignment NPD
• Jefferson Hospital Association, Inc

  • Rural Health Clinic/Center
  • Crossett, AR
  • NPI 1225799646
  NPD
• Jefferson Hospital Association, Inc

  • Family Medicine Physician
  • Pine Bluff, AR
  • NPI 1497102040
  NPD
• Icarepro of Texas, PA

  • Clinical Nurse Specialist
  • Texarkana, TX
  • NPI 1396193066
  NPD (past)

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1659633840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8324 WHITEVILLE RD",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716039313",
            "telephone_number": "870-879-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 DOLLARWAY RD",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716024126",
            "telephone_number": "870-536-3279",
            "fax_number": "870-536-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDY",
        "first_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki Pepino Gordon, RPT
• O T Gordon Jr., M.D.
• Jeffrey Tad Goss, PHARMD
• Shacoya Latrece Grady, LPN
• Rontae Marvell Edward Graham, DDS
• Gray-Millenbaugh Practitioner Healthcare, LLC
• Stacy Gray, RN
• Arriel S Green, BS, MS, MHPP
• Hillary Green, LCSW
• Madison Green

• Family Nurse Practitioner in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.