Phebe Joy Granderson, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

M002138 Issued in AR

Practice address

214 S 1St St Ste 203
Rogers, AR 72756-4504

Phone

(479) 935-3392

Fax

(866) 441-1301

NPI assigned

Aug 29, 2019

Last updated

Jan 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Phebe Joy Granderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

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.

• Eden Birth and Wellness

  • Advanced Practice Midwife
  • Rogers, AR
  • NPI 1538739875
  NPD Authorized official

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1760030027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 S 1ST ST STE 203",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564504",
            "telephone_number": "479-935-3392",
            "fax_number": "866-441-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 S 1ST ST STE 203",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564504",
            "telephone_number": "479-935-3392",
            "fax_number": "866-441-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDERSON",
        "first_name": "PHEBE",
        "middle_name": "JOY",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AR",
            "license": "M002138",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OK",
            "license": "M115216",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHEBE",
            "last_name": "GRANDERSON",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsey Ann Goucher, APRN
• GPB Enterprises LLC
• Alyssa Eden Graff, PA
• Corey Kendall Graham, PT
• Alexa Blaire Grand, PA-C
• Grant J Fowler D.D.S.
• Patrick Michael Grant Jr.
• Kelly B Gray, LCSW
• Rachel Gray
• Green Acre Easy Lliving

• Advanced Practice Midwife in Rogers, AR
• Providers in Rogers, AR by specialty
• Advanced Practice Midwife in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.