MARY E GRANDON (NPI# 1790754638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790754638 |
| Entity Type | Individual |
| Full Name | MARY E GRANDON |
| Credential | PA-C |
| Practice Address |
107 Koontz Ave. Ste. 200 Clendenin WV 25045 |
| Mailing Address |
Po Box 70 Dawes WV 25054 |
| Practice Telephone | 3045487272 |
| Practice Fax Number | 3045487149 |
| Mailing Telephone | 3047342040 |
| Mailing Fax Number | 3047342047 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 00616 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
107 KOONTZ AVE. STE. 200 |
| City | CLENDENIN |
| State | WV |
| Zip Code | 25045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669088753 | Tammie Ann Cummings | Technician | 1266 Kelliehillrd, Clendenin, WV 25045 | 2020-09-23 |
| 1467063289 | Barbara E Gross | Technician | 10546 Elk River Rd, Clendenin, WV 25045 | 2020-08-14 |
| 1437676392 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 8699 Elk River Rd North, Clendenin, WV 25045 | 2017-08-23 |
| 1982984324 | Jennifer Marie Snell | Pharmacist | 2 First Ave S, Clendenin, WV 25045 | 2011-08-17 |
| 1629290218 | Douglas Joseph Donovall Jr. | Pharmacist | 2 First Ave South, Clendenin, WV 25045 | 2007-05-03 |
| 1912085549 | Lawrence Henry Schoonover | Dentist | 1 French Street, Clendenin, WV 25045 | 2006-11-01 |
| 1437199742 | Cabin Creek Health Center, Inc. | Clinic/Center | 107 Koontz Ave., Suite 200, Clendenin, WV 25045 | 2006-06-07 |
| 1043660160 | Caitlyn Elizabeth Nelson | Dentist | 107 Koontz Ave Ste 200, Clendenin, WV 25045 | 2016-06-20 |
| 1285928804 | Clendenin Health Center Pharmacy At Riverview | Clinic/Center | 107 Koontz Ave, Clendenin, WV 25045 | 2011-05-31 |
| 1750681011 | Lindsay A Matuszkiewicz | Pharmacist | 10 Main Street, Clendenin, WV 25045 | 2010-11-02 |
| Find all providers in zip 25045 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811249956 | Jennifer Lynn Thayer | Physician Assistant | 107 Koontz Ave Ste 200, Clendenin, WV 25045-9581 | 2012-10-14 |
| 1073596102 | Kathleen Ann Lovin | Physician Assistant | 107 Koontz Ave, Clendenin, WV 25045-9578 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798321 | Trenton Ryan Johnson | Physician Assistant | 174 Country Ln, Kenna, WV 25248-7225 | 2020-10-26 |
| 1609475326 | Rebecca Whealen | Physician Assistant | 2026 Huber Rd, Charleston, WV 25314-2236 | 2020-10-23 |
| 1720686066 | Ana Brandt | Physician Assistant | 33 Medical Center Dr, Morgantown, WV 26505-4024 | 2020-10-09 |
| 1518564012 | Lauren Brianne Peyton | Physician Assistant | 5322 Indiana St Apt 4, South Charleston, WV 25309-1055 | 2020-10-07 |
| 1386251635 | Caitlin Estep | Physician Assistant | 3100 Maccorkle Ave Se Ste 802, Charleston, WV 25304-1233 | 2020-09-29 |
| 1336754639 | Brittany Marie Herber | Physician Assistant | 22 Solomons Ct, Hedgesville, WV 25427-3683 | 2020-09-14 |
| 1417568312 | Kelsea Martin | Physician Assistant | 6 Dogwood St, Philippi, WV 26416-1660 | 2020-08-13 |
| 1720617889 | Keri Bedillion | Physician Assistant | 527 Medical Park Dr Ste 306, Bridgeport, WV 26330-9010 | 2020-04-02 |
| 1912539628 | Abigail Renee Grant | Physician Assistant | 123 Main Ave, Nitro, WV 25143-1270 | 2020-02-11 |
| 1639719990 | Jessy Marie Hamrick | Physician Assistant | 149 Dutch Rd Apt 105, Charleston, WV 25302-2530 | 2020-01-14 |
| 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.