Mary E Grant, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

077037862N3 Issued in OR

Practice address

10140 SW Parkway
Portland, OR 97225-5008

Phone

(503) 215-2669

NPI assigned

Aug 19, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: mgrant120913@oc.providencedirect.org

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.

• Integral Health PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1861661241
  NPD (past)
• Providence Health & Services Oregon

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Portland, OR
  • NPI 1043366172
  NPD (past)
• Providence Health & Services Oregon

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
  • NPI 1396818993
  NPD (past)
• Providence Medical Group, PC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063570604
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1811989379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10140 SW PARKWAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255008",
            "telephone_number": "503-215-2669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 NE Halsey Street",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972134742",
            "country_code": "US",
            "telephone_number": "503-215-2669",
            "fax_number": "503-215-8465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6350 NE Halsey St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972134720",
            "country_code": "US",
            "telephone_number": "503-215-2669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "077037862N3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128111",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrant120913@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE Hoyt St Ste 315",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgrant120913@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "6350 NE Halsey St Ste 300",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972134720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jordan Alyssa Grant
• Kylie Morgan Grant
• Lora Grant
• Lyntressa Danielle Grant, PMHNP-BC
• Madeleine Suzanne Bullick Grant, PHARMD
• Melanie Janelle Grant, DMD
• Michael Grant
• Nancy Grant, M.D.
• Rowan M Grant
• Stephen Thomas Grant, LCSW

• Adult Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.