Grantham Medical, PLLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

GRANTHAM MEDICAL, PLLC

Practice address

133 Terrell Rd Unit 9
San Antonio, TX 78209-6329

Phone

(830) 221-6903

NPI assigned

Dec 16, 2024

Organization subpart

No

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

Authorized official

Name

Krista Grantham, PA-CNPI 1073920005

Title

Owner

Phone

(830) 221-6903

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Krista Grantham, PA-C

  • Surgical Physician Assistant
  • San Antonio, TX
  • NPI 1073920005
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1699582304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6141",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782090141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 TERRELL RD UNIT 9",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782096329",
            "telephone_number": "830-221-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANTHAM MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-221-6903",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmine Raenay Grant
• Jennifer K Grant, LCSW
• Sheena Mary Grant, M.D.
• Sheryl L Grant
• Thomas M. Grant, PHD, LCSW,LPC
• Krista Grantham, PA-C
• Lauren Grantham
• Zoe Grantham, BA, RBT
• Amber Grapevine, MS, RD
• Annaliese Grassia

• Surgical Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.