Shaylon Carlene Grant, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN0000015750 Issued in TN

Practice address

1800 E Lake Shore Dr
Decatur, IL 62521-3810

Phone

(217) 422-6100

Fax

(217) 422-3217

NPI assigned

Apr 1, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1992094742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-422-6100",
            "fax_number": "217-422-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-422-6100",
            "fax_number": "217-422-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "SHAYLON",
        "middle_name": "CARLENE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000015750",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209010154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01273952",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie K Gower, M.S. CCC-SLP
• Geniel Grabowski, LCSW
• Terrence M Graham, DPM,FACFAS
• Christopher Hastings Gram, MD
• Emilye Jessica Grant, PHYSICIAN ASSISTANT
• Maria Granzotti, M.D.
• Ronald James Grason, M.D.
• Jason Grauer, APRN
• Alexis Renee Graven
• Joshua Graves

• Family Nurse Practitioner in Decatur, IL
• Providers in Decatur, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.