DALE COURTNEY GRANTHAM MD NPI 1932140456

NPI Information

NPI: 1932140456
Provider Name: DALE COURTNEY GRANTHAM, MD
Classification: Emergency Medicine - 207PE0004X
Entity Type: Individual

Specialization: Emergency Medical Services

PECOS Registration: Yes

Address:
1110 BLUE SAGE RD NE
RIO RANCHO, NM
ZIP 87144
Phone: (509) 942-4793
Get Directions

Dale Courtney Grantham, MD is an emergency medical services emergency medicine in Rio Rancho, NM. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. Dale Courtney Grantham, MD NPI is 1932140456. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1110 BLUE SAGE RD NE
RIO RANCHO, NM
ZIP 87144-763
Phone: (509) 942-4793

The NPI 1932140456 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/8/2006 and was last updated on 5/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		MD00041473	WASHINGTON	No
2	207P00000X	Emergency Medicine		MD2012-0049193	NEW MEXICO	No
3	207PE0004X	Emergency Medicine	Emergency Medical Services	MD2012-0049193	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8317067	MEDICAID	WASHINGTON
2	3075GR	OTHER	WASHINGTON	BSWA
3	605960008	OTHER	WASHINGTON	DEEOIC
4	0202687	OTHER	WASHINGTON	LIWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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