Individual provider Active NPI

David Jonathan Grant Sr., CRNA

  • Certified Registered Nurse Anesthetist
  • Norfolk, VA
National Provider Identifier
1851337695
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024165006 Issued in VA
Practice address
600 Gresham Dr
Norfolk, VA 23507-1904
Phone
(757) 473-0055
Fax
(757) 473-0075
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024165006 VA Primary
Certified Registered Nurse Anesthetist 367500000X ARNP3350272 FL
Certified Registered Nurse Anesthetist 367500000X 2238 SC

Addresses

Primary practice location

600 Gresham Dr
Norfolk, VA 23507-1904

Mailing address

134 Business Park Dr
Virginia Beach, VA 23462-6523
Phone (757) 473-0055

Other identifiers 1

IdentifierTypeStateIssuer
AN0808MedicaidSC

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2238SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Group of Tennessee, P. C. Nurse Anesthetist, Certified Registered CurrentSince Dec 3, 2012 Accepting new patients
Southwest Anesthesia, PC Past Accepting new patients
Anesthesia Associates of Richmond, Inc Past Accepting new patients
Piedmont Triad Anesthesia, PA Nurse Anesthetist, Certified Registered PastSince Jul 20, 2004 Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Zanesville Anesthesia Physicians Inc Past Accepting new patients
Prisma Health-Upstate Past Accepting new patients
Anesthesia Services of Kentucky, PLLC Past Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients
Kansas Professional Anesthesia and Pain Management Specialists, P.a. PastSince May 14, 2001 Accepting new patients

Locations

135 W Ravine Rd
Ste 5-B
Kingsport, TN 37660
Phone (423) 224-3460

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

Organizations & group practices 10

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1851337695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BUSINESS PARK DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626523",
            "telephone_number": "757-473-0055",
            "fax_number": "757-473-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-473-0055",
            "fax_number": "757-473-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "DAVID",
        "middle_name": "JONATHAN",
        "name_suffix": "Sr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024165006",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3350272",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2238",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0808",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.