DR. ALISSA MICHELLE GRANT M.D. Full NPI Record 1003016700
Pediatrics in Mena, AR
Complete NPI Dataset
The following table represents the complete NPI 1003016700 dataset for Alissa Grant in 900 HIGHWAY 71 N MENA, AR 71953. The data table includes a list of all field names, values and definitions of the complete NPI record. The NPI dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.
| Name | Value | Definition |
|---|---|---|
| NPI | 1003016700 | The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
| Entity Type Code | 1 | Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
| Provider Last Name Legal Name | GRANT | The last name of the provider. If the provider is an individual, this is the legal name. |
| Provider First Name | ALISSA | The first name of the provider, if the provider is an individual. |
| Provider Middle Name | MICHELLE | The middle name of the provider, if the provider is an individual. |
| Provider Name Prefix Text | DR. | The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal. |
| Provider Credential Text | M.D. | The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS. |
| Provider First Line Business Mailing Address | 900 HIGHWAY 71 N | The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’. |
| Provider Business Mailing Address City Name | MENA | The city name in the mailing address of the provider being identified. |
| Provider Business Mailing Address State Name | AR | The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’. |
| Provider Business Mailing Address Postal Code | 719534304 | The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’. |
| Provider Business Mailing Address Country Code If outside U S | US | |
| Provider Business Mailing Address Telephone Number | 4793945439 | The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
| Provider Business Mailing Address Fax Number | 4793944357 | The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
| Provider First Line Business Practice Location Address | 900 HIGHWAY 71 N | |
| Provider Business Practice Location Address City Name | MENA | Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form. |
| Provider Business Practice Location Address State Name | AR | The State code in the location of the provider being identified. |
| Provider Business Practice Location Address Postal Code | 719534304 | The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
| Provider Business Practice Location Address Country Code If outside U S | US | The country code in the location address of the provider being identified. |
| Provider Business Practice Location Address Telephone Number | 4793945439 | The telephone number associated with the location address of the provider being identified. |
| Provider Business Practice Location Address Fax Number | 4793944357 | The fax number associated with the location address of the provider being identified. |
| Provider Enumeration Date | 7/20/2007 | The date the provider was assigned a unique identifier (assigned an NPI). |
| Last Update Date | 6/11/2021 | The date that a record was last updated or changed. |
| Provider Gender Code | F | The code designating the provider’s gender if the provider is a person. |
| Healthcare Provider Taxonomy Code 1 | 208000000X | Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
| Provider License Number 1 | E-7744 | The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
| Provider License Number State Code 1 | AR | The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
| Healthcare Provider Primary Taxonomy Switch 1 | Y | |
| Is Sole Proprietor | N | Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
| NPI Certification Date | 6/11/2021 | |