Nikolai Ivanov Grammer, ADT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1981 Issued in MD

Practice address

2 W Aylesbury Rd
Timonium, MD 21093-4101

Phone

(410) 561-9591

Fax

(410) 561-9396

NPI assigned

Jul 14, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1568080745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W AYLESBURY RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210934101",
            "telephone_number": "410-561-9591",
            "fax_number": "410-561-9396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W AYLESBURY RD",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210934101",
            "telephone_number": "410-561-9591",
            "fax_number": "410-561-9396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMMER",
        "first_name": "NIKOLAI",
        "middle_name": "IVANOV",
        "credential": "ADT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "1981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makayla Gordon
• Stuart Marshall Gordon, D.D.S.
• Susan Elizabeth Gorell, MD
• Mona Elisabeth Gorman, DDS
• Desiree Grady
• Hillary Grande, M.ED, BCBA, LBA
• Alexandra Gray, M.A.
• Greater Baltimore Medical Center, Inc.
• Greater Baltimore Medical Center, Inc.
• Greater Baltimore Medical Center, Inc.

• Addiction (Substance Use Disorder) Counselor in Timonium, MD
• Providers in Timonium, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

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