Individual provider Active NPI

Nicole S Grey, FNP

  • Family Nurse Practitioner
  • Palm Beach Gardens, FL
National Provider Identifier
1417765298
Registry record updated Dec 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11036654 Issued in FL
Practice address
11501 N Military TRL
Palm Beach Gardens, FL 33410-6507
Phone
(561) 805-2100
NPI assigned
Dec 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11036654 FL Primary

Addresses

Primary practice location

11501 N Military TRL
Palm Beach Gardens, FL 33410-6507

Mailing address

2413 NW 98TH Ter
Coral Springs, FL 33065-4930
Phone (954) 937-1779

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11036654FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1735084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735084800000",
    "number": "1417765298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 NW 98TH TER",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654930",
            "telephone_number": "954-937-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 N MILITARY TRL",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106507",
            "telephone_number": "561-805-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "NICOLE",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-25",
        "last_updated": "2024-12-25",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11036654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2024; 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.