Individual provider Active NPI

Helena B Grandgenett, CRNA

  • Certified Registered Nurse Anesthetist
  • Destin, FL
National Provider Identifier
1891720538
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9168155 Issued in FL
Practice address
4485 Furling LN
Destin, FL 32541-5331
Phone
(850) 650-7606
Fax
(850) 337-1698
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP9168155 FL Primary

Addresses

Primary practice location

4485 Furling LN
Destin, FL 32541-5331

Mailing address

4485 Furling LN
Destin, FL 32541-5331
Phone (850) 650-7606

Other identifiers 2

IdentifierTypeStateIssuer
G2796OtherFLBCBS
303110108MedicaidFL

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
ARNP9168155FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Florida Anesthesia Consultants Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
The Anesthesia Group, P.a. Past Accepting new patients
Broad Anesthesia Associates Past Accepting new patients

Organizations & group practices 3

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1891720538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 FURLING LN",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325415331",
            "telephone_number": "850-650-7606",
            "fax_number": "850-337-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 FURLING LN",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325415331",
            "telephone_number": "850-650-7606",
            "fax_number": "850-337-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDGENETT",
        "first_name": "HELENA",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9168155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G2796",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303110108",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.