Lynn Grant

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

3090 N Goliad St Ste 102
Rockwall, TX 75087-7008

Phone

(469) 897-5040

NPI assigned

Jun 21, 2024

Last updated

Jun 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Custom Creations, LLC

  • Prosthetic/Orthotic Supplier
  • Rowlett, TX
  • NPI 1497579569
  NPD Authorized official

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1720822109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 N GOLIAD ST",
            "address_2": "SUITE 102-PMB 817",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "75087",
            "telephone_number": "469-897-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 N GOLIAD ST STE 102",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750877008",
            "telephone_number": "469-897-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia E Gossett, LPC
• Heather Graham, LPC
• Charla Gayle Granberry, FNP
• Jaimee Granberry, LPC
• Emily Grant
• Roman Grant, DDS
• Jessica Lynn Gray, P.T.
• Michelle Gray
• Rachel Gray
• Greater Dallas Healthcare Corporation

• Prosthetic/Orthotic Supplier in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.