Connie Marie Grandia, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9651 Issued in MN

Practice address

134 Southview St
Owatonna, MN 55060-3241

Phone

(507) 451-1120

Fax

(507) 444-6287

NPI assigned

Jul 21, 2006

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

Other identifiers 1

Other names 1

• Connie Marie Grandia Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: connie.grandia@gfhc.eclinicaldirectplus.com

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1699796052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "507-451-1120",
            "fax_number": "507-444-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 SOUTHVIEW ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603241",
            "telephone_number": "507-451-1120",
            "fax_number": "507-444-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDIA",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767608500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "GRANDIA",
            "middle_name": "MARIE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catherine A Glovka, RD
• Naila Goenka, MD
• Golden Pearle LLC
• Wendy Grages
• Grand St Paul CVS LLC
• Amanda Susan Griswold, LICSW
• Allyssa Michelle Gronseth
• Krystal Marie Gross
• Ryan Guildner
• Avrahom Aharon Gurwitz, MD, MPH

• Physician Assistant in Owatonna, MN
• Providers in Owatonna, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.