RYAN GRANGE (NPI# 1295194629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295194629 |
| Entity Type | Individual |
| Full Name | RYAN GRANGE |
| Credential | P.A |
| Practice Address |
1851 Old Highway 66 Unit 1 Edgewood NM 87015 |
| Mailing Address |
12127b Hwy 14 N Ste 5 Cedar Crest NM 87008-9499 |
| Practice Telephone | 5052862396 |
| Practice Fax Number | 5052862398 |
| Mailing Telephone | 5052815180 |
| Mailing Fax Number | 5052815320 |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA 2016-0016 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1851 OLD HIGHWAY 66 UNIT 1 |
| City | EDGEWOOD |
| State | NM |
| Zip Code | 87015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740772490 | Laura Hunsucker | Physical Therapist | 1090 Mountain Valley Road, Edgewood, NM 87015 | 2018-05-30 |
| 1376895250 | Bianca Genco-morrison | Social Worker | 17 Venus Rd. West, Edgewood, NM 87015 | 2012-10-03 |
| 1447541909 | Rona H Vanwilligen | Physical Therapist | 1851 Highway 333, 2-b, Edgewood, NM 87015 | 2011-05-02 |
| 1679717789 | Alan Mannheimer | Pediatrics | 104 Quail Trail, Unit B, Edgewood, NM 87015 | 2009-04-21 |
| 1003085705 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 66 State Road #344, Edgewood, NM 87015 | 2008-02-27 |
| 1821270828 | Fowler Enterprises, Inc. | Physical Therapist | 1851-2b Old Highway 66, Edgewood, NM 87015 | 2007-11-30 |
| 1366630121 | Jeana Spindle | Speech-Language Pathologist | 27 Camino Estribor, Edgewood, NM 87015 | 2007-10-05 |
| 1679794457 | Sharon Louise Meyer | Social Worker | 14 El Prado, Edgewood, NM 87015 | 2007-05-01 |
| 1912035478 | Cecilia Gonzales Morris | Occupational Therapist | 204 Dinkle Road, Edgewood, NM 87015 | 2007-02-28 |
| 1396870861 | Stephen L Harrington | Dentist | 1851 Old Hwy 66, Suite C, Edgewood, NM 87015 | 2007-02-23 |
| Find all providers in zip 87015 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689795320 | Danielle Roberts | Physician Assistant | 51 Mercedes Way, Edgewood, NY 11717-8368 | 2007-04-02 |
| 1205995578 | Bruce Donald Lewis Jr. | Physician Assistant | 2719 Pulaski Hwy, Edgewood, MD 21040-1315 | 2006-12-06 |
| 1366539652 | Suzanne Michelle Fernbach | Physician Assistant | 560 S Loop Rd, Edgewood, KY 41017-3405 | 2006-10-06 |
| 1144265745 | Kristina Holtzapfel | Physician Assistant | 560 S Loop Rd, Edgewood, KY 41017-3405 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386284602 | Christopher Whorley | Physician Assistant | 4683 Idlewilde Ln Se, Albuquerque, NM 87108-3421 | 2020-01-15 |
| 1053836809 | Alysha Gallegos | Physician Assistant | 6112 Molinero Ct Sw, Albuquerque, NM 87105-6814 | 2017-08-13 |
| 1164978540 | Deborah L Thorne | Physician Assistant | 111 W Lucero Ave Ste 6, Las Cruces, NM 88005-1829 | 2016-08-26 |
| 1134572738 | Weston Bradley Graff | Physician Assistant | 703 Christopher Dr, Belen, NM 87002-2617 | 2016-07-19 |
| 1720445562 | Rebecca Gahan Brown | Physician Assistant | 150 N Roadrunner Pkwy, Las Cruces, NM 88011 | 2016-01-25 |
| 1508232240 | Edward R Watson | Physician Assistant | 2530 S Telshor Blvd Ste 207, Las Cruces, NM 88011-4975 | 2015-08-17 |
| 1306225180 | Allison Rose Crossey | Physician Assistant | 201 Cedar Street Se, Suite 6600, Albuquerque, NM 87106 | 2015-05-26 |
| 1528452208 | Taylor Bottari | Physician Assistant | 208 W Dl Ingram, Cannon Afb, NM 88103 | 2015-03-20 |
| 1336543115 | Pamela O Black Md, P.a., Dba Quadra Health Institute | Physician Assistant | 3820 Commons Ave Ne # M, Albuquerque, NM 87109-5831 | 2014-10-22 |
| 1396155206 | Jennifer Brynn Bendokas | Physician Assistant | 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 | 2014-04-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.