NPI Code Detail JSON Logo

1689295479 NPI number — GRANT NORMAN GELLERT MD

NPI Number: 1689295479
Health Care Provider/Practitioner: GRANT NORMAN GELLERT MD

Information about “1689295479” NPI (GRANT NORMAN GELLERT MD) exists in 1689295479 in HTML format HTML  |  1689295479 in plain Text format TXT  |  1689295479 in PDF (Portable Document Format) PDF  |  1689295479 in an XML format XML  formats.

NPI Number : 1689295479 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689295479",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GELLERT",
    "FirstName": "GRANT",
    "MiddleName": "NORMAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1854 ALFRESCO PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOUISVILLE",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "40205-1860",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-448-6665",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1220 MISSOURI AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JEFFERSONVILLE",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "47130-3725",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "812-283-2581",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/03/2020",
    "LastUpdateDate": "05/30/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208D00000X",
          "TaxonomyName": "General Practice Physician",
          "LicenseNumber": "60244",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207P00000X",
          "TaxonomyName": "Emergency Medicine Physician",
          "LicenseNumber": "01095828A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.