Individual provider Active NPI

Nicole Nilmeier Grant, MD

  • Obesity Medicine (Internal Medicine) Physician
  • Palo Alto, CA
National Provider Identifier
1902007198
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
License
C139028 Issued in CA
Practice address
3801 Miranda Ave
Palo Alto, CA 94304-1290
Phone
(650) 493-5000
Fax
(919) 383-6128
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Internal Medicine) Physician 207RB0002X C139028 CA Primary
Internal Medicine Physician 207R00000X 2007-00058 NC

Addresses

Primary practice location

3801 Miranda Ave
Palo Alto, CA 94304-1290

Mailing address

4022 Bristol Rd
Durham, NC 27707-5403
Phone (199) 430-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140411000606 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4789639295

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-00058NCMDInternal Medicine Physician
C139028CAMDObesity Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1902007198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 BRISTOL RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075403",
            "telephone_number": "199-430-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041290",
            "telephone_number": "650-493-5000",
            "fax_number": "919-383-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "NICOLE",
        "middle_name": "NILMEIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "CA",
            "license": "C139028",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2007-00058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.