Nicholas James Granderson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

289884 Issued in NY

Practice address

300 Hamilton Ave
White Plains, NY 10601-1810

Phone

(914) 345-0700

NPI assigned

Nov 19, 2009

Last updated

May 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• The Mental Health Association of Westchester County, Inc.

  • Community/Behavioral Health Agency
  • White Plains, NY
  • NPI 1942306873
  NPD
• The Mental Health Association of Westchester County - Social Care Network

  • Case Manager/Care Coordinator
  • Tarrytown, NY
  • NPI 1760320659
  NPD (past)

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1437487071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 WHITE PLAINS RD STE 510",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915152",
            "telephone_number": "914-345-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HAMILTON AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011810",
            "telephone_number": "914-345-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3060 East Tremont Ave.",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104615726",
            "country_code": "US",
            "telephone_number": "718-239-1790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANDERSON",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-19",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "289884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Graham, RPH
• Malcolm Sandford Graham, D.D.S.
• Otecia Graham
• Richard Edwin Graham, D.M.D.
• Kelly Brooke Graling, PH.D.
• Deanna Grandville
• Matteo Graniero
• Bailey Grant
• Janice Elizabeth Grant, NP
• Stacy Gravesandy

• Licensed Practical Nurse in White Plains, NY
• Providers in White Plains, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.