Grace Ann McMicken, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1539A Issued in ND

Practice address

3921 Lockport St
Bismarck, ND 58503-5541

Phone

(701) 751-3128

NPI assigned

Nov 5, 2024

Last updated

Nov 5, 2024By the provider in NPPES

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

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.

• Rehabauthority, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1730159690
  NPD

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1710700901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 LOCKPORT ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 LOCKPORT ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035541",
            "telephone_number": "701-751-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMICKEN",
        "first_name": "GRACE",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ND",
            "license": "1539A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Djaninn Mae Shannon McKibben, PA-C
• Michelle L McKim
• Crystal McLaughlin
• Carol Grace McLean, MSCCCSLP
• Jessica McLindsay, AU.D.
• Steve McNichols
• Daniel Peter McPherson, PHARM.D.
• Debra Johnson McPherson
• Samantha Mead, OTR/L
• Sinderella Meadows

• Physical Therapy Assistant in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Physical Therapy Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.