Peter Mark Granderson (NPI# 1750660528, PAC ID# 0244403111) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1750660528 |
| PAC ID by PECOS | 0244403111 |
| Professional Enrollment ID | I20111109000811 |
| Full Name | Peter Mark Granderson |
| Organization Legal Name | ST FRANCIS HOUSE NWA INC |
| Address |
375 N Rupple Rd Fayetteville AR 72704-6110 |
| Phone Number | 4797180290 |
| Gender | M |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 0042262495 |
| Number of Group Practice Members | 28 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040001 | SILOAM SPRINGS REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 375 N Rupple Rd, Fayetteville, AR 72704-6110 | 4797180290 | ST FRANCIS HOUSE NWA INC |
| Organization Legal Name | ST FRANCIS HOUSE NWA INC |
| Physicians | 41 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rachel Anne Reich | Nurse Practitioner | St Francis House Nwa Inc | 1500 N Mount Olive St, Siloam Springs School Based Health Center, Siloam Springs, AR 72761-9509 |
| Tracie E Fullove | Family Medicine | St Francis House Nwa Inc | 3162 W Martin Luther King Blvd, Fayetteville, AR 72704-7679 |
| Mark A Worley | Psychiatry | St Francis House Nwa Inc | 614 E Emma Ave, 300 Community Clinic Springdale, Springdale, AR 72764-4469 |
| Richard T Pruiksma | Family Medicine | St Francis House Nwa Inc | 500 S Mount Olive St, 200 Community Clinic Siloam Springs Med, Siloam Springs, AR 72761-3602 |
| Martha Morgan | Family Practice | St Francis House Nwa Inc | 900 S Powell St, Springdale, AR 72764-5645 |
| Donald G Clay | Psychiatry | St Francis House Nwa Inc | 375 N Rupple Rd, Fayetteville, AR 72704-6110 |
| Marie Chantale Crosse | Nurse Practitioner | St Francis House Nwa Inc | 801 Viney Grove Rd, Prairie Grove, AR 72753-2623 |
| Kathy Lynn Mayhew | Family Medicine | St Francis House Nwa Inc | 1233 W Poplar St, Community Clinic Rogers Medical, Rogers, AR 72756-4245 |
| Sheldon Riklon | Family Medicine | St Francis House Nwa Inc | 500 S Mount Olive St, 200 Community Clinic Siloam Springs Med, Siloam Springs, AR 72761-3602 |
| Laura Lee Mendenhall | Clinical Social Worker | St Francis House Nwa Inc | 500 S Mount Olive St, 200 Community Clinic Siloam Springs Med, Siloam Springs, AR 72761-3602 |
| Street Address |
375 N RUPPLE RD |
| City | FAYETTEVILLE |
| State | AR |
| Zip | 72704-6110 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Donald G Clay | Psychiatry | St Francis House Nwa Inc | 375 N Rupple Rd, Fayetteville, AR 72704-6110 |
| Leslie Noelle Goolsby | Nurse Practitioner | St Francis House Nwa Inc | 375 N Rupple Rd, Fayetteville, AR 72704-6110 |
| Vicki H Moore | Nurse Practitioner | St. Francis House Nwa, Inc. | 375 N Rupple Rd, Fayetteville, AR 72704-6110 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert R Orgain | Optometry | 3316 W Grove Dr, Suite 1, Fayetteville, AR 72704-5003 | |
| Steven F Spencer | Family Medicine | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| Jason R Young | Nurse Practitioner | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| Jason T Keech | Physical Therapy | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| Heather L Hutchison | Nurse Practitioner | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| David Luke Knox | Neurosurgery | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| Thomas K Rogerson | Physical Therapy | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| Fines Levi Hudson | Physician Assistant | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| Cody J Osbourn | Physical Therapy | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| Joseph Paul | Physical Therapy | Washington Regional Medical System | 3561 Johnson Mill Blvd, Fayetteville, AR 72704-5026 |
| Find all physicians in zip 72704 | |||
| City | FAYETTEVILLE |
| Zip Code | 72704 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | FAYETTEVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Peter Mark Granderson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.