John Anthony Gragnani, M.D.
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Wildwood, MO
NPI 1962499236 · NPPES record last updated Jan 18, 2024
Key facts
- NPI
- 1962499236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 35494 (MO)
- Practice address
- 1510 Scofield Valley LN
Wildwood, MO 63038-1349 - Phone
- (636) 458-4350
- Fax
- (636) 458-4350
- NPI assigned
- Oct 3, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 35494 | MO | Yes |
Addresses
Primary practice location
1510 Scofield Valley LN
Wildwood, MO 63038-1349
Mailing address
1510 Scofield Valley LN
Wildwood, MO 63038-1349
Phone (636) 458-4350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201128915 | Medicaid | MO |
Other providers in Wildwood, MO
- Global Village Therapy, LLC
- Suzanne S. Golden
- Alana Goldstein Jacobs
- Keridan Gossrau
- Grace Home Healthcare, LLC
- Amber Grayson
- Emily Gregor
- Gregory S. St. John, DDS, PC
- Megan Marie Grobe
- Megan Marie Hampton
All providers in Wildwood, MO · Physical Medicine & Rehabilitation Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.