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MS. KIMBERLY GILLIAM GRANT PA-C
NPI 1871569855
Physician Assistant - Medical in Fresno, CA

Active since February 28, 2006PECOS Enrolled
6107 N 1ST ST STE 103, FRESNO, CA 93710(559) 432-4963 Get Directions Write a Review

NPPES record last updated: May 6, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2020, Sep 26, 2018 (2 updates tracked since 2018).

About Ms. Kimberly Gilliam Grant Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KIMBERLY GILLIAM GRANT PA-C (NPI 1871569855) is an individual medical provider in Fresno, California, licensed in Florida (9109580) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1871569855
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMS. KIMBERLY GILLIAM GRANTCredential: PA-C
Location Address6107 N 1ST ST STE 103Fresno, CA 93710-5460
Mailing Address6107 N 1st St Ste 103Fresno, CA 93710-5460 · (559) 432-4963
Phone(559) 432-4963
Sole ProprietorNo
Enumeration DateFebruary 28, 2006
Last NPPES UpdateMay 6, 20202 updates tracked since enumeration
NPPES CertifiedMay 6, 2020
✔ NPI 1871569855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in FL · 9109580✔ Licensed in SC · TL1232✔ Licensed in TN · PA642
6107 N 1ST ST STE 103, Fresno, CA 93710
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Secondary Practice Locations 2

Location 11590 Freedom Blvd, Suite AFlorence, SC 29505-6040 · Phone (843) 629-1791 · Fax (843) 629-1794
Location 21718 Mockingbird LnLakeland, FL 33801 · Phone (863) 272-1550

Other Identifiers 1

Medicaid0576APASC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kimberly Gilliam Grant Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAREN ANN LEDEE-LEWIS NP
Internal Medicine
6107 N 1ST ST STE 103
FRESNO, CA 93710
Fresno County (559) 432-5697

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Grant's NPI number?

The NPI number for Kimberly Grant is 1871569855. It was assigned to this individual provider in the NPPES registry on February 28, 2006.

Where is Kimberly Grant located?

Kimberly Grant practices at 6107 N 1st St Ste 103, Fresno, CA 93710. The listed phone number is (559) 432-4963.

What is Kimberly Grant's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kimberly Grant enrolled in Medicare?

Yes. Kimberly Grant is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Grant was last updated on May 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.