Joshua Herold Vernon Granly, REGISTERED NURSE

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

2473835 Issued in MN

Practice address

2524 Hannah Ave NW
Bemidji, MN 56601-2110

Phone

(218) 210-2100

Fax

(218) 444-5677

NPI assigned

Nov 4, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tru Healthcare, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gilbert, AZ
  • NPI 1386016822
  NPD (past)

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1669137683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 HANNAH AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012110",
            "telephone_number": "218-210-2100",
            "fax_number": "218-444-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 HANNAH AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012110",
            "telephone_number": "218-210-2100",
            "fax_number": "218-444-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANLY",
        "first_name": "JOSHUA",
        "middle_name": "HEROLD VERNON",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "2473835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• GPH Bemidji, Inc
• Holly A Graber, PTA
• John Alexander Eric Graham, PSYCHOLOGIST
• Grand St Paul CVS LLC
• Grand St. Paul CVS LLC
• Great River Dentistry of Bemidji, P.a.
• Great River Dentistry of Bemidji, PLLC
• Great River Psychological Services, P.a.
• Great Western Medical Group PLLC
• Margaret Grob, PT

• Home Health Registered Nurse in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Home Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.