Individual provider Active NPI

Grant Wysong

  • Critical Care Medicine Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1699652545
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
71016996A Issued in IN
Practice address
7250 Clearvista Dr Ste 355
Indianapolis, IN 46256-5609
Phone
(317) 621-6262
NPI assigned
Aug 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 28222590A IN
Critical Care Medicine Nurse Practitioner 363LC0200X 71016996A IN Primary

Addresses

Primary practice location

7250 Clearvista Dr Ste 355
Indianapolis, IN 46256-5609

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-1699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20250909002246 IN Practitioner - Nurse Practitioner 9234631060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

7250 Clearvista Dr
Suite 355
Indianapolis, IN 46256-5609
Phone (317) 621-5676

Hospital & facility affiliations

  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28222590AINMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 15, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 15, 2025 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7250 Clearvista Dr
Ste 355
Indianapolis, IN 46256
Phone (317) 621-5673

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1699652545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 CLEARVISTA DR STE 355",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462565609",
            "telephone_number": "317-621-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSONG",
        "first_name": "GRANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "IN",
            "license": "28222590A",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "IN",
            "license": "71016996A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.