Individual provider Active NPI

Grace Nicholas, MD

  • Radiation Oncology Physician
  • Salt Lake City, UT
National Provider Identifier
1912767666
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
14244239-1205 Issued in UT
Practice address
1950 Circle of Hope Dr RM 1570
Salt Lake City, UT 84112-5500
Phone
(801) 581-2121
NPI assigned
Mar 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 14244239-1205 UT Primary

Addresses

Primary practice location

1950 Circle of Hope Dr RM 1570
Salt Lake City, UT 84112-5500

Mailing address

1950 Circle of Hope Dr RM 1570
Salt Lake City, UT 84112-5500
Phone (801) 581-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20251015000491 UT Order and Referring Only - Radiation OncologyPractitioner - Radiation Oncology 2163919929

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1912767666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR RM 1570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR RM 1570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "UT",
            "license": "14244239-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.