Nathan Lee Granneman, M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

2012023532 Issued in MO

Practice address

401 N Keene St
Columbia, MO 65201-6625

Phone

(573) 876-1600

Fax

(573) 876-1606

NPI assigned

Jun 22, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Emergency MedicineAlso: Family Practice, Sports Medicine

Education

University of Missouri, Columbia School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boone Hospital Center Hospital, Columbia, MO, CCN 260068

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nathan.granneman@115443077021700.direct.elationemr.com

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.

• Boone Physician Services, LLC

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1760893259
  Medicare reassignment Care Compare group NPD

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

• CH Allied Services, Inc

  dba Boone Hospital Center

  • Cardiac Rehabilitation Clinic/Center
  • Columbia, MO
  • NPI 1548734734

  Hospital

  Care Compare affiliation
• CH Allied Services, Inc.

  dba Boone Hospital Center

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1902817844
  Care Compare affiliation

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1689960171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016625",
            "telephone_number": "573-876-1600",
            "fax_number": "573-876-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016625",
            "telephone_number": "573-876-1600",
            "fax_number": "573-876-1606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W Business Loop 70 Ste 275",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652032522",
            "country_code": "US",
            "telephone_number": "573-874-0008",
            "fax_number": "573-875-5350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANNEMAN",
        "first_name": "NATHAN",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MO",
            "license": "2012023532",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MO",
            "license": "2012023532",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200008322",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Michele Grace, LPC
• Lisa Marie Graessle, WHNP
• Chante Graham, RBT
• Scott T Graham, PT
• Jill Aubey Granneman, RD, LD
• Emily Grannemann
• Laura L Grant, M.D.
• William Mark Grant, M.D.
• Granting Lives Home Care, LLC (Granting Lives Home Care)
• Maureen W Grau

• Occupational Medicine Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Occupational Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.