Individual provider Active NPI

Courtney Grant

  • Physician Assistant
  • Lompoc, CA
National Provider Identifier
1740063247
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
136 N 3Rd St
Lompoc, CA 93436-7002
Phone
(805) 736-1253
Fax
(805) 736-5355
NPI assigned
Aug 17, 2023
Last updated
Nov 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

136 N 3Rd St
Lompoc, CA 93436-7002

Mailing address

1515 E Ocean Ave
Lompoc, CA 93436-7092
Phone (805) 737-3300

Other practice location 1

1075 E Betteravia Rd
Santa Maria, CA 93454-7023
Phone (805) 621-7651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231201002552 CA Practitioner - Physician Assistant 2860840782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lompoc Valley Medical CenterGroup PAC ID 9739275595, 90 clinicians

Practice addresses (Care Compare)

1225 N H St
Lompoc, CA 93436-3301
Phone (805) 737-8700

136 N 3Rd St
Lompoc, CA 93436-7002
Phone (805) 737-3300

1515 E Ocean Ave
Lompoc, CA 93436-7092
Phone (805) 737-3321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lompoc Valley Medical Center CurrentSince Nov 20, 2023 Accepting new patients

Locations

136 N 3rd St
Lompoc, CA 93436
Phone (805) 736-1253

1515 E Ocean Ave
Lompoc, CA 93436
Phone (805) 737-3300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: courtney.grant@lvmc.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1740063247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E OCEAN AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934367092",
            "telephone_number": "805-737-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N 3RD ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934367002",
            "telephone_number": "805-736-1253",
            "fax_number": "805-736-5355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 E Betteravia Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934547023",
            "country_code": "US",
            "telephone_number": "805-621-7651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lompoc, CA

Sources for this page

Verify at the official NPI Registry.