BENJAMIN JOSEPH GRANDY (NPI# 1285976571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285976571 |
| Entity Type | Individual |
| Full Name | BENJAMIN JOSEPH GRANDY |
| Credential | D.O. |
| Practice Address |
7950 W Jefferson Blvd Fort Wayne IN 46804 |
| Mailing Address |
250 N Shadeland Ave Ste 200 Indianapolis IN 46219-4959 |
| Practice Telephone | 2604357001 |
| Mailing Telephone | 3179623834 |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2020-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 02005096A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300004384 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1800 Orleans St, Baltimore, MD 212870010 | 4105028879 | |
| 7950 W Jefferson Blvd, Fort Wayne, IN 46804 | 2604357001 | |
| 410 Pilgrim Blvd, Hartford City, IN 473481382 | 7653480300 | |
| 500 W Votaw St, Portland, IN 473711322 | 2607267131 |
| Street Address |
7950 W JEFFERSON BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760486187 | Heather J. Wolfe | Pediatrics | 7950 W Jefferson Blvd, Suite 212, Fort Wayne, IN 46804-4140 | 2005-06-13 |
| 1831798354 | Dorian Raymone Tate | Nurse Anesthetist, Certified Registered | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-10-26 |
| 1528665585 | Alexis Kate Felger | Nurse Practitioner | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-10-02 |
| 1114534054 | Mary Catherine Richter | Specialist/Technologist, Other | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-09-24 |
| 1538778386 | Lori Elizabeth Jackson | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-07-28 |
| 1831708965 | Anna N. Kemler | Nurse Practitioner | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-07-24 |
| 1699383307 | David James Mansfield | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-07-20 |
| 1932726452 | Joseph Egbert | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-06-30 |
| 1245851872 | Lauren Tirey | Occupational Therapist | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-05-05 |
| 1609415421 | Mikhaila Sailor | Dietitian, Registered | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2019-12-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154777613 | Michael J Bojrab | Emergency Medicine | 6720 Kirkdale Dr, Fort Wayne, IN 46815-5524 | 2016-05-13 |
| 1073939450 | Whitney Miller | Emergency Medicine | 10343 Dawsons Creek Blvd Ste A, Fort Wayne, IN 46825 | 2014-03-10 |
| 1538401732 | Nicholas Salvatore Costanza | Emergency Medicine | 4225 Frost Grass Dr, Henry Ford Macomb Hospitals, Fort Wayne, IN 46845-8010 | 2013-03-26 |
| 1235459603 | Sheila K Pittenger | Emergency Medicine | 3684 New Vision Drive, Fort Wayne, IN 46845 | 2010-06-08 |
| 1881808012 | Roderick G Morrison | Emergency Medicine | 11109 Parkview Plaza Drive, Fort Wayne, IN 46845-1701 | 2007-05-09 |
| 1902982796 | Walter Osborne Jackson | Emergency Medicine | 10329 Greenoak Blvd, Fort Wayne, IN 46814-9546 | 2006-10-27 |
| 1255416947 | Kamlesh Patel | Emergency Medicine | 1638 Carroll Rd, Fort Wayne, IN 46845-9373 | 2006-10-25 |
| 1245259944 | Stephen Mcconnell | Emergency Medicine | 2825 Barry Knoll Way, Fort Wayne, IN 46845-1944 | 2006-07-19 |
| 1326067000 | Dennis Dale Mansfield | Emergency Medicine | 7950 W Jefferson Blvd Ste 2121, Fort Wayne, IN 46804-4140 | 2006-07-19 |
| 1588683122 | Aiman Hassan | Emergency Medicine | 6036 Trier Rd, Fort Wayne, IN 46815-5337 | 2006-07-18 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on BENJAMIN JOSEPH GRANDY.
| 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.