Mary Grandon, PA-C
NPI 1790754638 · Physician Assistant · Clendenin, WV
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mary Grandon, PA-C is a Physician Assistant provider in Clendenin, WV (NPI 1790754638).
Provider details
- NPI number
- 1790754638
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 00616 (WV)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-03-14
- Last updated
- 2020-05-21
- Certified
- 2020-05-21
Frequently asked questions
- What is Mary Grandon's NPI number?
- Mary Grandon's National Provider Identifier (NPI) is 1790754638, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mary Grandon's specialty?
- Mary Grandon is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Mary Grandon located?
- Mary Grandon's practice location on file with NPPES is 107 Koontz Ave. Ste. 200, Clendenin, WV 25045.
- What is Mary Grandon's phone number?
- The practice phone number listed in the NPPES registry for Mary Grandon is (304) 548-7272.
- Does Mary Grandon accept Medicare?
- Mary Grandon is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mary Grandon's NPI active?
- Yes — Mary Grandon's NPI (1790754638) is active in the NPPES registry as of the last update on 2020-05-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.