Individual provider Active NPI

Taylor M Grantham, PA-C

  • Physician Assistant
  • Midland, MI
National Provider Identifier
1831720226
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4611 Campus Ridge Dr
Midland, MI 48640-9533
Phone
(989) 839-3500
NPI assigned
Feb 4, 2020
Last updated
May 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

4611 Campus Ridge Dr
Midland, MI 48640-9533

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 839-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200409003540 MI Practitioner - Physician Assistant 7810326923 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 633-8018

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Apr 2, 2020 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Jun 1, 2021 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Jun 1, 2021 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Jun 1, 2021 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Jun 1, 2021 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Jun 1, 2021 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Apr 2, 2020 Accepting new patients

Locations

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

4611 N Campus Ridge Dr
Midland, MI 48640
Phone (844) 832-1956

Interoperability endpoints

  • Direct secure messaging: twaltz94625@mymichiganhealth.midirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1831720226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "989-839-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 CAMPUS RIDGE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486409533",
            "telephone_number": "989-839-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "TAYLOR",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.