Individual provider Active NPI

Nicole Grigoryants, DO

  • Diagnostic Radiology Physician
  • Mobile, AL
National Provider Identifier
1376302810
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DO.4266 Issued in AL
Practice address
2451 University Hospital Dr # 212
Mobile, AL 36617-2300
Phone
(251) 471-7152
Fax
(251) 471-7008
NPI assigned
Mar 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DO.4266 AL Primary

Addresses

Primary practice location

2451 University Hospital Dr # 212
Mobile, AL 36617-2300

Mailing address

2451 University Hospital Dr
Mobile, AL 36617-2300
Phone (251) 471-7117

Other practice location 1

9330 State Road 54
Trinity, FL 34655-1808
Phone (727) 834-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240515003235 FL Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 4082055405
I20251003000535 AL Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 4082055405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1376302810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300",
            "telephone_number": "251-471-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR # 212",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300",
            "telephone_number": "251-471-7152",
            "fax_number": "251-471-7008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9330 State Road 54",
            "address_purpose": "LOCATION",
            "city": "Trinity",
            "state": "FL",
            "postal_code": "346551808",
            "country_code": "US",
            "telephone_number": "727-834-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIGORYANTS",
        "first_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "DO.4266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.