Active NPI
Nicole Dawn Grange, PA-C
- Physician Assistant
- Milford, MI
National Provider Identifier
1356534770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601005010
- Practice address
- 1181 N Milford Rd
Suite 100
Milford, MI 48381-1061 - Phone
- (248) 685-0444
- Fax
- (248) 684-0900
- NPI assigned
- Aug 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601005010 | MI | Primary |
Addresses
Primary practice location
1181 N Milford Rd
Suite 100
Milford, MI 48381-1061
Mailing address
1181 N Milford Rd
Suite 100
Milford, MI 48381-1061
Phone (248) 685-0444
Other names 1
- Nicole Dawn Joseph
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milford Obstetrics & Gynecology P C | Past | Accepting new patients | |
| VHS Physicians of Michigan | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Obstetrics & Gynecology Physician
- Milford, MI
- NPI 1760525893
-
- Internal Medicine Physician
- Southfield, MI
- NPI 1073827101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314230400000",
"number": "1356534770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1181 N MILFORD RD",
"address_2": "SUITE 100",
"city": "MILFORD",
"state": "MI",
"postal_code": "483811061",
"telephone_number": "248-685-0444",
"fax_number": "248-684-0900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1181 N MILFORD RD",
"address_2": "SUITE 100",
"city": "MILFORD",
"state": "MI",
"postal_code": "483811061",
"telephone_number": "248-685-0444",
"fax_number": "248-684-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANGE",
"first_name": "NICOLE",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-20",
"last_updated": "2011-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601005010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "JOSEPH",
"middle_name": "DAWN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Milford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.