Nicole Marie Granger, LMT, LMP

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

15945 Issued in OR

Practice address

13712 NE 20TH Ave
Vancouver, WA 98686-2698

Phone

(360) 574-5944

NPI assigned

Jul 14, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Nicole Marie Robinson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Active Health Chiropractic PC

  • Chiropractor
  • Vancouver, WA
  • NPI 1962586818
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1003045832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9638 SW LARSON RD",
            "city": "GASTON",
            "state": "OR",
            "postal_code": "971197721",
            "telephone_number": "503-998-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13712 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862698",
            "telephone_number": "360-574-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LMT, LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "15945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "ROBINSON",
            "middle_name": "MARIE",
            "credential": "LMT, LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Perry Graham, M.D.
• Shannon Helen Graham
• Gregory D. Gramstad, M.D.
• Ramona J Granath, NNP
• Magdalena Grande, MS
• Trisha Lynn Granger
• Sarah Granstra
• Elizabeth Grant, LSWAIC
• Elizabeth K Grant, M.A. CCC-SLP
• James D Grant, M.D.

• All providers in Vancouver, WA
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.