Active NPI
John J Grandner, CRNP
- Nurse Practitioner
- Rockville, MD
National Provider Identifier
1699843094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN47957
- Practice address
- 2101 E Jefferson St
Rockville, MD 20852-4908 - Phone
- (202) 898-5104
- Fax
- (202) 898-5474
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN47957 | DC | Primary |
Addresses
Primary practice location
2101 E Jefferson St
Rockville, MD 20852-4908
Mailing address
2101 East Jefferson Street
Ppqa Medicare Compliance Unit 6 West
Rockville, MD 20852-4908
Phone (301) 816-2414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325721600000",
"number": "1699843094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 EAST JEFFERSON STREET",
"address_2": "PPQA MEDICARE COMPLIANCE UNIT 6 WEST",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208524908",
"telephone_number": "301-816-2414",
"fax_number": "301-388-1740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 E JEFFERSON ST",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208524908",
"telephone_number": "202-898-5104",
"fax_number": "202-898-5474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDNER",
"first_name": "JOHN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2012-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "DC",
"license": "RN47957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.