Individual provider Active NPI

Dana Grant, NP-C

  • Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1750740965
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
901401 Issued in MS
Practice address
874 Barnes Crossing Rd
Tupelo, MS 38804-0909
Phone
(662) 841-0002
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 901401 MS Primary

Addresses

Primary practice location

874 Barnes Crossing Rd
Tupelo, MS 38804-0909

Mailing address

874 Barnes Crossing Rd
Tupelo, MS 38804-0909
Phone (662) 841-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20161117000734 MS Practitioner - Nurse Practitioner 5193004000 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901401MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midnight-Medical, Inc. CurrentSince Apr 10, 2022 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Nov 1, 2021 Accepting new patients
Grant Family Medical LLC Current Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Nov 1, 2021 Accepting new patients
Convenient Care Clinic, LLC Past Accepting new patients

Locations

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

848 S Madison St
Tupelo, MS 38801
Phone (662) 844-4177

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1750740965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 BARNES CROSSING RD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388040909",
            "telephone_number": "662-841-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 BARNES CROSSING RD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388040909",
            "telephone_number": "662-841-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "DANA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.