DR. DAVID BRYANT GRANTHAM (NPI# 1548200322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548200322 |
| Entity Type | Individual |
| Full Name | DR. DAVID BRYANT GRANTHAM |
| Credential | ED.D. |
| Practice Address |
296 Gamble Ave Maryville TN 37801-4943 |
| Practice Telephone | 8659806464 |
| Practice Fax Number | 8659776823 |
| Mailing Telephone | 8659806464 |
| Mailing Fax Number | 8659776823 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2008-09-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC0000001693 | TN | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | LMT0000000581 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS | 015174 | 01 |
| MS | TAX ID | 431961623 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023247244 | David C. Grantham | Surgery | 818 N Emporia, Suite 200, Wichita, KS 67214 | 2009-07-09 |
| 1689871683 | David Wayne Grantham | Surgery | 5 First Village Drive, Pinehurst, NC 28374-2000 | 2007-07-02 |
| Street Address |
296 GAMBLE AVE |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37801-4943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912536582 | Andrea Waldrop | Pharmacist | 103 Foothills Mall Drive, Maryville, TN 37801 | 2020-04-06 |
| 1134664147 | Complete Vision Care Pllc | Optometrist | 2410 Us Hwy 411 S, Maryville, TN 37801 | 2016-12-29 |
| 1144634114 | James Muscari | Dentist | 824 W. Lamar Alexander Pkwy, Maryville, TN 37801 | 2014-06-17 |
| 1245465483 | Respiratory Home Care of Bristol, LLC | Durable Medical Equipment & Medical Supplies | 637 Morganton Square Dr, Maryville, TN 37801 | 2009-05-18 |
| 1063682383 | William R Pedersen | Optometrist | 730 West Lamar Alexander Pkwy, Maryville, TN 37801 | 2008-03-03 |
| 1124218573 | Liberty Assisted Living LLC | Assisted Living Facility | 312 Mcmaster Pl, Liberty Assisted Living LLC, Maryville, TN 37801 | 2007-07-31 |
| 1447467493 | Amanda G Clement | Nurse Practitioner | 1427 William Blount Drive, Maryville, TN 37801 | 2007-05-17 |
| 1396873758 | David T Cope | Audiologist | 821 Ross Drive, Maryville, TN 37801 | 2007-02-28 |
| 1649345406 | Adult & Family Dentistry, Inc. | Dentist | 1740 Big Springs Rd, Maryville, TN 37801 | 2006-11-21 |
| 1225109523 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 330 Southdowne Dr, Maryville, TN 37801 | 2006-11-10 |
| Find all providers in zip 37801 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376104703 | Lynne Cabra Delorenzo | Counselor | 370 S Long Hollow Rd, Maryville, TN 37801-8320 | 2019-06-26 |
| 1215284617 | Janet Luzmoor | Counselor | 109 East Summit Dr, Maryville, MO 64468 | 2012-08-06 |
| 1841585544 | Paula Luna | Counselor | 311 E 3rd St, Maryville, MO 64468-1706 | 2011-06-10 |
| 1477787422 | Joshua Beeler | Counselor | 1325 Tapoco Ave, Maryville, TN 37801-4632 | 2009-05-05 |
| 1508909938 | Ken Thom Counseling Inc | Counselor | 515 W Cooper, Maryville, MO 64468-2417 | 2007-02-15 |
| 1144378282 | John Bayless Judd | Counselor | 400 S Washington St, Maryville, TN 37804-5801 | 2007-01-08 |
| 1407946056 | Annabel Lee Agee | Counselor | 209 High St, Maryville, TN 37804-5914 | 2006-10-13 |
| 1609970763 | Cornerstone Counseling, P.C. | Counselor | 20 A Professional Park Drive, Maryville, IL 62062 | 2006-09-11 |
| 1780693515 | Kim Hasty | Counselor | 20 Professional Park Dr # A, Maryville, IL 62062-5669 | 2006-08-08 |
| 1912982893 | Kenneth T. Thom | Counselor | 515 W Cooper St, Maryville, MO 64468-2417 | 2005-12-13 |
| Find all providers in MARYVILLE | ||||
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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.