Linette I Grange, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02003654 Issued in IN

Practice address

1025 Manchester Ave
Wabash, IN 46992-1425

Phone

(260) 563-7421

Fax

(260) 569-2284

NPI assigned

Jun 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: lgrange@yourcarecommunity.org

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510272000000",
    "number": "1982646485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 NEW VISION DR BLDG B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451703",
            "telephone_number": "260-266-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MANCHESTER AVE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921425",
            "telephone_number": "260-563-7421",
            "fax_number": "260-569-2284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5921 W State Road 46",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474049359",
            "country_code": "US",
            "telephone_number": "812-935-8866",
            "fax_number": "812-935-8860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGE",
        "first_name": "LINETTE",
        "middle_name": "I",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2017-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201007920",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01123184",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baylie Madison Giek
• Adam Ray Gillum
• Melissa Glass, MA
• John Terry Godfrey, D.C.
• Tiffiany Gosnell, DMD
• Akeem Green
• Michael Lydell Haarer, LMHC
• Stuart Douglass Hall
• Constance Mae Harmon, LMHC
• Mary J Harrell, LCSW

• All providers in Wabash, IN
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; 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.