Individual provider Active NPI

Nicole Lynn Grilliot

  • Case Manager/Care Coordinator
  • Troy, OH
National Provider Identifier
1922517903
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
550 Summit Ave
Troy, OH 45373-3047
Phone
(937) 335-0361
Fax
(937) 339-7816
NPI assigned
Sep 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X OH Primary

Addresses

Primary practice location

550 Summit Ave
Troy, OH 45373-3047

Mailing address

PO Box 631
Troy, OH 45373-0631
Phone (937) 335-0361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Darke County Recovery Services Multi-Specialty CurrentSince Jul 24, 2022 Accepting new patients
Darke County Mental Health Clinic, Inc Multi-Specialty PastSince Jul 24, 2022 Accepting new patients

Locations

550 Summit Ave
Troy, OH 45373
Phone (937) 335-0361

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/recoveryandwellnessohio/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922517903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453730631",
            "telephone_number": "937-335-0361",
            "fax_number": "937-339-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SUMMIT AVE",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453733047",
            "telephone_number": "937-335-0361",
            "fax_number": "937-339-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLIOT",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.