Nicole Megan Grant

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11434 Issued in MN

Practice address

6545 France Ave S Ste 450
Edina, MN 55435-2122

Phone

(952) 920-8525

NPI assigned

Aug 24, 2016

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

Practice roles

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.

• Public Hospital District No 4 King County Washington

  • Critical Access Hospital
  • Snoqualmie, WA
  • NPI 1902846546
  NPD (past)

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1730634361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33650 6TH AVE S",
            "address_2": "STE 100",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036754",
            "telephone_number": "937-219-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S STE 450",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352122",
            "telephone_number": "952-920-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "NICOLE",
        "middle_name": "MEGAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60663259",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Wilson Grahn, MD
• Jessica L Grajczyk, DO
• Grand St Paul CVS LLC
• Grand St. Paul CVS LLC
• Allyson M Grant, PA-C
• Ryan Michael Grant, CRNA
• Shelly Ann Grantham, LPC
• Ava Marie Grapsy, RDN
• Katie Grausam, PA-C
• Tember Graves

• Physical Therapist in Edina, MN
• Providers in Edina, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.