Individual provider Active NPI

William P Grant, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Virginia Beach, VA
National Provider Identifier
1982706685
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0103000572 Issued in VA
Practice address
760 Independence Blvd
Suite 1
Virginia Beach, VA 23455-6206
Phone
(757) 497-7575
Fax
(757) 490-1795
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0103000572 VA Primary

Addresses

Primary practice location

760 Independence Blvd
Suite 1
Virginia Beach, VA 23455-6206

Mailing address

PO Box 5447
Virginia Beach, VA 23471-0447
Phone (757) 497-7575

Other identifiers 1

IdentifierTypeStateIssuer
9301658MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111219000615 VA Practitioner - Podiatry 9234288796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Foot and Ankle Center PCGroup PAC ID 5496717100, 2 clinicians

Practice addresses (Care Compare)

760 Independence Blvd
Suite 1
Virginia Beach, VA 23455-6206
Phone (757) 497-7575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
51.22 of 100Reported as individual
Quality
27.48
Promoting interoperability
61
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision19
Removal of tissue120
Removal of skin lesions144
Removal of nail tissue46
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Physical Therapy LLC CurrentSince Feb 15, 2022 Accepting new patients
Tidewater Foot & Ankle Center, PC Foot & Ankle Surgery CurrentSince Aug 31, 1983 Accepting new patients
Diabetic Foot Center of Tidewater Foot & Ankle Surgery Past Accepting new patients

Locations

762 Independence Blvd
Ste 771
Virginia Beach, VA 23455
Phone (757) 497-7575

760 Independence Blvd
Ste 1
Virginia Beach, VA 23455
Phone (757) 497-7575

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1982706685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5447",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234710447",
            "telephone_number": "757-497-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 INDEPENDENCE BLVD",
            "address_2": "SUITE 1",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556206",
            "telephone_number": "757-497-7575",
            "fax_number": "757-490-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "WILLIAM",
        "middle_name": "P",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103000572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9301658",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.