Individual provider Active NPI

Izaak William Granger, APRN-CNP

  • Acute Care Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1780095281
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.16074 Issued in OH
Practice address
3525 Olentangy River Rd Ste 5300
Columbus, OH 43214-3937
Phone
(614) 566-3500
Fax
(614) 533-0150
NPI assigned
May 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.365402 OH
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.16074 OH Primary

Addresses

Primary practice location

3525 Olentangy River Rd Ste 5300
Columbus, OH 43214-3937

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other practice location 1

460 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 293-8714

Other identifiers 2

IdentifierTypeStateIssuer
P01452479OtherOHRAILROAD MEDICARE
0106545MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address igranger1196606@direct.ohiohealth.com OhioHealth Physician Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140808001279 OH Practitioner - Nurse Practitioner 0749407187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

3525 Olentangy River Rd
Suite 5300
Columbus, OH 43214-3937
Phone (614) 566-2680

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.365402OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jan 1, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Jan 1, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3525 Olentangy River Rd
Ste 5300
Columbus, OH 43214
Phone (614) 261-1991

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

680 Park Ave W
Mansfield, OH 44906
Phone (419) 522-1100

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1780095281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 OLENTANGY RIVER RD STE 5300",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143937",
            "telephone_number": "614-566-3500",
            "fax_number": "614-533-0150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-293-8714",
            "fax_number": "614-293-3277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "IZAAK",
        "middle_name": "WILLIAM",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.365402",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.16074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01452479",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106545",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "igranger1196606@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "3525 Olentangy River Rd Ste 5300",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.