Active NPI
Janet Joan Grange, M.D.
- Surgery Physician
- Papillion, NE
National Provider Identifier
1780710558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 19630
- Practice address
- 401 E Gold Coast Rd
Suite 329
Papillion, NE 68046-4194 - Phone
- (402) 934-9323
- Fax
- (402) 934-9471
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 19630 | NE | Primary |
| Surgery Physician | 208600000X | 33814 | IA |
Addresses
Primary practice location
401 E Gold Coast Rd
Suite 329
Papillion, NE 68046-4194
Mailing address
401 E Gold Coast Rd
Suite 329
Papillion, NE 68046-4194
Phone (402) 934-9323
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34173 | Other | NE | BCBS OF NEBRASKA # |
| 47083782500 | Medicaid | NE | |
| 2224212 | Medicaid | IA | |
| 17-81009 | Other | NE | UNITED HEALTH CARE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33814 | IA | MD | Surgery Physician |
| 19630 | NE | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1780710558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E GOLD COAST RD",
"address_2": "SUITE 329",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680464194",
"telephone_number": "402-934-9323",
"fax_number": "402-934-9471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E GOLD COAST RD",
"address_2": "SUITE 329",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680464194",
"telephone_number": "402-934-9323",
"fax_number": "402-934-9471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANGE",
"first_name": "JANET",
"middle_name": "JOAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NE",
"license": "19630",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "33814",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NEBRASKA #",
"identifier": "34173",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47083782500",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2224212",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE #",
"identifier": "17-81009",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Papillion, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.