Mark Gilbert Grand, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

R4698 Issued in MO

Practice address

8820 Ladue Rd Ste 203
Saint Louis, MO 63124-2080

Phone

(314) 367-1181

Fax

(314) 968-5117

NPI assigned

Jul 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/f62890b5-77ff-44bd-a981-0a0981047b35/

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.

• River Rock Behavioral Health, LLC

  • Clinical Psychologist
  • Saint Louis, MO
  • NPI 1376157453
  NPD
• Hermann Area Hospital District

  • Family Medicine Physician
  • Hermann, MO
  • NPI 1083749188
  NPD (past)
• Retina & Vitreous Consultants Inc

  • Ophthalmology Physician
  • Saint Louis, MO
  • NPI 1255452603

  Retina Specialist

  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1841298551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 LADUE RD STE 203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242080",
            "telephone_number": "314-367-1181",
            "fax_number": "314-968-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 LADUE RD STE 203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242080",
            "telephone_number": "314-367-1181",
            "fax_number": "314-968-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAND",
        "first_name": "MARK",
        "middle_name": "GILBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MO",
            "license": "R4698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven J Granberg, MD
• Grand Manor Health Care Center, L.L.C.
• Grand Manor Nursing & Rehabilitation Center, L.L.C.
• Grand Manor SNF Opco LLC
• Grand Medical Group LLC
• Allyson M Granden, NP-C
• Laura Granderson
• Grandmom Honey LLC
• Thomas M Graney, PA
• Dorothy K Grange, MD

• Retina Specialist (Ophthalmology) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Retina Specialist (Ophthalmology) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.