NPIMap

Individual provider Active NPI

Christopher Lee Granger, MD

  • Family Medicine Physician
  • Deridder, LA
National Provider Identifier
1861472110
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.200031 Issued in LA
Practice address
403 W 8TH St
Deridder, LA 70634-5507
Phone
(337) 463-8977
Fax
(337) 462-3093
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.200031 LA Primary

Addresses

Primary practice location

403 W 8TH St
Deridder, LA 70634-5507

Mailing address

403 W 8TH St
Deridder, LA 70634-5507
Phone (337) 463-8977

Other identifiers 1

IdentifierTypeStateIssuer
1627062MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050810000033 LA Practitioner - Family Practice 0648230854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

403 W 8TH St
Deridder, LA 70634-5507
Phone (337) 463-8977

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.200031LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chris L Granger M D LLC Family Medicine CurrentSince Jul 1, 2005 Accepting new patients
Brighton Bridge Hospice LLC Family Medicine Past Accepting new patients
Westwood Manor Nursing Home, LLC Past Accepting new patients
Rosepine Retirement & Rehabilitation Center, LLC Past Accepting new patients

Locations

714 High School Dr
Deridder, LA 70634
Phone (337) 463-4272

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

403 W 8th St
Deridder, LA 70634
Phone (337) 463-8977

Interoperability endpoints

  • Direct secure messaging: chrisgranger@fhcla.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1861472110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W 8TH ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706345507",
            "telephone_number": "337-463-8977",
            "fax_number": "337-462-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W 8TH ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706345507",
            "telephone_number": "337-463-8977",
            "fax_number": "337-462-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.200031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1627062",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

Verify at the official NPI Registry.