Individual provider Active NPI

Edward Claude Granger, H.I.S.

  • Hearing Instrument Specialist
  • Sioux City, IA
National Provider Identifier
1811240849
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
Practice address
4301 Sergeant Rd Ste 109
Sioux City, IA 51106
Phone
(712) 293-2222
Fax
(712) 293-2491
NPI assigned
Oct 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 765 NE
Hearing Instrument Specialist 237700000X IA Primary
Audiologist-Hearing Aid Fitter 237600000X IA

Addresses

Primary practice location

4301 Sergeant Rd Ste 109
Sioux City, IA 51106

Mailing address

6700 Washington Ave S
Eden Prairie, MN 55344-3405
Phone (612) 351-1529

Other practice location 1

7829 Chicago Plz
Omaha, NE 68114-3653
Phone (402) 933-1453

Other practice location 2

1405 N Cotner Blvd Ste 303
Lincoln, NE 68505-1691
Phone (402) 466-6402

Other identifiers 1

IdentifierTypeStateIssuer
10025747800MedicaidNE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
765NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Hearing Centers, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1811240849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 WASHINGTON AVE S",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443405",
            "telephone_number": "612-351-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 SERGEANT RD STE 109",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51106",
            "telephone_number": "712-293-2222",
            "fax_number": "712-293-2491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7829 Chicago Plz",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681143653",
            "country_code": "US",
            "telephone_number": "402-933-1453",
            "fax_number": "402-763-8872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 N Cotner Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685051691",
            "country_code": "US",
            "telephone_number": "402-466-6402",
            "fax_number": "503-659-5968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "EDWARD",
        "middle_name": "CLAUDE",
        "credential": "H.I.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-15",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NE",
            "license": "765",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IA",
            "license": null,
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025747800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.