Nicholas David Grotjohan

Primary specialty

ContractorTaxonomy code 171W00000X

License

W473363 Issued in FL

Practice address

5881 NW 16TH PL Apt 219
Sunrise, FL 33313-4776

Phone

(954) 297-7369

NPI assigned

May 22, 2023

Last updated

Aug 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grotjohan Insurance Inc

  • Adult Companion
  • Sunrise, FL
  • NPI 1083453633
  NPD Authorized official

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1427740364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 W OAKLAND PARK BLVD STE 376",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516808",
            "telephone_number": "954-297-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 NW 16TH PL APT 219",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333134776",
            "telephone_number": "954-297-7369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTJOHAN",
        "first_name": "NICHOLAS",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "W473363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H1019-023",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alycia Gresham, OTR/L
• Susan Nicole Grey-Parkes
• Melanie Jean Gritz Bond, DMD
• Theodore Grossman, D.M.D.
• Grotjohan Insurance Inc
• Priyanka Grover, MBBS
• Grow Up Behavioral Case Management LLC
• Aileen Marie Grullon-Colon, MA, CCC-SLP
• Dana Kimberly Grynbaum, P.T.
• Dean Guadagna, DO

• Contractor in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Contractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.