JARED MCKINLEY GRANTHAM (NPI# 1134464506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134464506 |
| Entity Type | Individual |
| Full Name | JARED MCKINLEY GRANTHAM |
| Credential | CRNA |
| Practice Address |
1108 Ross Clark Cir Dothan AL 36301-3022 |
| Mailing Address |
Po Box 1928 Dothan AL 36302-1928 |
| Practice Telephone | 3347938087 |
| Practice Fax Number | 3347938191 |
| Mailing Telephone | 3347938087 |
| Mailing Fax Number | 3347938191 |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2012-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 1-137611 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1108 ROSS CLARK CIR |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-3022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679576268 | Judith L Bosse | Nurse Practitioner | 1108 Ross Clark Cir, Hospitalist Office, Dothan, AL 36301-3022 | 2005-05-27 |
| 1811597073 | Michael Brian Pierce | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-10-27 |
| 1659990901 | Robert Dale Garrett | Nurse Anesthetist, Certified Registered | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-04-15 |
| 1861028607 | Richard Henry Jester | Physician Assistant | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-03-12 |
| 1467017335 | Keaton Peak | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301 | 2019-05-07 |
| 1396214060 | Shalita Clark | Psychiatry & Neurology | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2018-11-24 |
| 1619452760 | Drew Mckenzie Hubbard | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2018-09-25 |
| 1609359926 | Amber Salmon | Dietitian, Registered | 1108 Ross Clark Cir, Dothan, AL 36301-3024 | 2018-09-12 |
| 1255825832 | Shannon Louette Skaug | Nurse Practitioner | 1108 Ross Clark Cir, Dothan, AL 36301-3024 | 2018-06-18 |
| 1225529712 | Vyshnavi Kone | Student in an Organized Health Care Education/Training Program | 1108 Ross Clark Cir, Dothan, AL 36301 | 2018-05-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073663589 | William G Smith Jr. | Nurse Anesthetist, Certified Registered | 103 Nottoway Blvd, Dothan, AL 36303-2979 | 2007-01-10 |
| 1720026891 | Linda S. Brock | Nurse Anesthetist, Certified Registered | 36 Hampton Way, Dothan, AL 36305-6319 | 2006-06-02 |
| 1801875620 | James A Kennedy | Nurse Anesthetist, Certified Registered | 2802 Ross Clark Circle, Dothan, AL 36301 | 2006-01-11 |
| 1861471732 | Alice M Hickey | Nurse Anesthetist, Certified Registered | 1450 Ross Clark Circle, Dothan, AL 36301 | 2006-01-10 |
| 1871114090 | Hillary Ryan Mclemore | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-4000 | 2020-04-28 |
| 1659990901 | Robert Dale Garrett | Nurse Anesthetist, Certified Registered | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-04-15 |
| 1972076859 | Tillman Hall | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-1056 | 2019-01-03 |
| 1023525169 | Michael Aaron Allen | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-1056 | 2018-01-09 |
| 1508373143 | Derek Austin Dean | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-1056 | 2018-01-04 |
| 1790201903 | Gut PC | Nurse Anesthetist, Certified Registered | 1450 Ross Clark Cir Ste 400, Dothan, AL 36301-4770 | 2017-08-18 |
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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.