Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary E Grandon, PA-C

Individual provider Physician Assistant · NPI 1790754638

Mary E Grandon, PA-C is a Physician Assistant in Clendenin, West Virginia. Qualified in 1992, 34 years ago. Practices with Cabin Creek Health Center Inc, a 45-clinician group and accepts Medicare assignment. Licensed in West Virginia.

Years since qualifying
34
Licensed in
WV
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

107 Koontz Ave Ste 200
Clendenin, WV 25045
Phone: (304) 548-7272
Fax: (304) 548-7149
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 00616 (WV)

Record details

NPI number1790754638
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 14, 2006
Last updated in NPPESMay 21, 2020
Certification dateMay 21, 2020
Mailing addressPo Box 70, Dawes, WV 25054

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice Cabin Creek Health Center Inc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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