Mikaelah Grant

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

4500 Forbes Blvd Ste 200-E21
Lanham, MD 20706-6312

Phone

(833) 421-2796

NPI assigned

Feb 6, 2025

Sex

Female

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

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 and National Provider Directory roles.

• Crownz Heavenly Palace LLC

  • Prosthetic/Orthotic Supplier
  • Washington, DC
  • NPI 1679385306
  NPD Authorized official

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767398400000",
    "number": "1649084856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 H ST NE STE 1509",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 FORBES BLVD STE 200-E21",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066312",
            "telephone_number": "833-421-2796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Spring Rd NW Apt 301",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200101994",
            "country_code": "US",
            "telephone_number": "410-900-7909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MIKAELAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-06",
        "last_updated": "2026-01-03",
        "certification_date": "2026-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "DC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Graf, PA-C
• Trevor Graham, MBA, LMT, C-MMP
• Tyra A Graham
• Barbara Grant, PHARM.D.
• Judy A Grant, MD
• Nikesha Lauris Gray, M.S., OTR/L
• Taja Gray, CD
• Carlisle Greaves, LCSW-C
• Ashley Kanae Green
• Calen Green

• Prosthetic/Orthotic Supplier in Lanham, MD
• Providers in Lanham, MD by specialty
• Prosthetic/Orthotic Supplier in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2026; 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.