Individual provider Active NPI

Nicole A Grant, D.O.

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1811312739
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.012264 Issued in OH
Practice address
5100 W Broad St
Columbus, OH 43228-1607
Phone
(614) 544-1000
Fax
(614) 544-1751
NPI assigned
Feb 28, 2014
Last updated
Aug 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 34.012264 OH Primary

Addresses

Primary practice location

5100 W Broad St
Columbus, OH 43228-1607

Mailing address

5100 W Broad St
Columbus, OH 43228-1607
Phone (614) 544-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV, KY3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170215000345 OH Practitioner - Emergency Medicine 4880977917 Reassigns benefits to 3 organizations
I20191014003456 WV Practitioner - Emergency Medicine 4880977917 Reassigns benefits to 2 organizations
I20211013003616 KY Practitioner - Emergency Medicine 4880977917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia School of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied West Virginia Emergency Physicians PLLCGroup PAC ID 8325326648, 7 clinicians

Practice addresses (Care Compare)

2900 1St Ave
Huntington, WV 25702-1241
Phone (304) 526-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Ohio LLC Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Mount Carmel Health System CurrentSince Jan 1, 2017 Accepting new patients
Cep America - Ohio LLC Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Allied West Virginia Emergency Physicians PLLC Emergency Medicine CurrentSince Jul 30, 2019 Accepting new patients
Valley Emergency Physicians Ohio LLC Emergency Medicine CurrentSince Jul 30, 2019 Accepting new patients
West Fairview Emergency Physicians LLC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Racine Observation Medical Group, PLLC Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Mount Carmel Health System CurrentSince Jan 1, 2017 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

1408 Campbell Dr
Ironton, OH 45638
Phone (740) 533-9710

444 N Cleveland Ave
Ste 130
Westerville, OH 43082
Phone 6147940481102

477 Cooper Rd
Ste 300
Westerville, OH 43081
Phone (614) 898-8808

500 S Cleveland Ave
Westerville, OH 43081
Phone (380) 898-4000

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

Interoperability endpoints

  • Direct secure messaging: ngrant78746@direct.kdhealth.us

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1811312739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281607",
            "telephone_number": "614-544-1000",
            "fax_number": "614-544-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281607",
            "telephone_number": "614-544-1000",
            "fax_number": "614-544-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-28",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.012264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.