Nichole E Geist, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601014099 Issued in MI

Practice address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Phone

(269) 552-2823

Fax

(269) 552-2964

NPI assigned

Sep 16, 2021

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1669142147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "269-552-2823",
            "fax_number": "269-552-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "269-552-2823",
            "fax_number": "269-552-2964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 N Hollywood Way Ste 102",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915055031",
            "country_code": "US",
            "telephone_number": "866-727-8274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEIST",
        "first_name": "NICHOLE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601014099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669142147",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Ross Futa, PHARM.D
• Edward Fynn, PHARMD
• Tracey Lee Gangluff, MS,CCC,SLP
• Dena Nichole Garnett, PT, DPT
• Shondalin A Gates
• Kathleen George
• Margaret Ann Gerwels, FNP
• Nabeela Safdar Gill, PHARMD
• Sibil Gill, DO
• Blair Gingerich

• Physician Assistant in Granger, IN
• Providers in Granger, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.