| Grant Needham, PA-C | |
|
1107 N Casitas Hill Loop, Washington, UT 84780-8922 | |
| (435) 632-7681 | |
| (435) 250-3615 |
| Full Name | Grant Needham |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 26 Years |
| Location | 1107 N Casitas Hill Loop, Washington, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699870899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 284995-1206 (Utah) | Primary |
| 363AM0700X | Physician Assistant - Medical | 284995-1206 (Utah) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Enhabit Home Health Of Southern Utah | St george, UT | Home health agency |
| Canyon Home Care Of Southern Utah | St. george, UT | Home health agency |
| Zion's Way Home Health | St. george, UT | Home health agency |
| Summit Home Health St. George | St. george, UT | Home health agency |
| Applegate Homecare | South ogden, UT | Home health agency |
| Intermountain Health St George Regional Hospital | St george, UT | Hospital |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| St. George Rehabilitation | St. george, UT | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Centric Physicians Intermountain Region, Pllc | 2466880851 | 10 |
| Entity Name | Southern Utah Ear Nose & Throat LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679733869 PECOS PAC ID: 4082772777 Enrollment ID: O20081024000241 |
| Entity Name | Robert D Pearson PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487900015 PECOS PAC ID: 6204083975 Enrollment ID: O20121005000023 |
| Entity Name | Centric Physicians Intermountain Region, PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467097071 PECOS PAC ID: 2466880851 Enrollment ID: O20200318001146 |
| Entity Name | Pai Participant 1 LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093371312 PECOS PAC ID: 8123351954 Enrollment ID: O20200416000875 |
| Entity Name | Healthdrive Medical Services Intermountain PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518836436 PECOS PAC ID: 1951880152 Enrollment ID: O20260209001644 |
| Mailing Address | Practice Location Address |
|---|---|
| Grant Needham, PA-C 1107 N Casitas Hill Loop, Washington, UT 84780-8922 Ph: (435) 632-7681 | Grant Needham, PA-C 1107 N Casitas Hill Loop, Washington, UT 84780-8922 Ph: (435) 632-7681 |
Cassidy Marie Iverson, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 3350 E Dungeon Dr, Washington, UT 84780 Phone: 801-580-1558 |