GRACE INTEGRATED HEALTH & WELLNESS, LLC (NPI# 1184242174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184242174 |
| Entity Type | Organization |
| Organization Name | GRACE INTEGRATED HEALTH & WELLNESS, LLC |
| Practice Address |
1000 South Beckham Tyler TX 75701 |
| Mailing Address |
Po Box 9995 Tyler TX 75711-2995 |
| Practice Telephone | 9032845158 |
| Mailing Telephone | 9037058509 |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |
| Authorized Official Name | JENNIFER RETTIG (CEO) |
| Authorized Official Telephone | 9037058509 |
| Authorized Official Credential | NURSE PRACTITION |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WI0500X |
Registered Nurse Specialization: Infusion Therapy |
Nursing Service Providers | ||
| N | 363LC1500X |
Nurse Practitioner Specialization: Community Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NPI1265977144 | 05 |
| Street Address |
1000 SOUTH BECKHAM |
| City | TYLER |
| State | TX |
| Zip Code | 75701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| 1609225515 | Goodwill Industries of East Texas, Inc. | Voluntary or Charitable | 1817 Loop 323 Wsw, Tyler, TX 75701 | 2016-06-10 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329728 | Rachel E Fouse | Nurse Practitioner | 323 S Fannin Ave, Tyler, TX 75702-7321 | 2020-02-29 |
| 1942845243 | Nicolette Jane Silverio | Nurse Practitioner | 6116 Wilshire Dr, Tyler, TX 75703-4160 | 2019-11-10 |
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1356996573 | Katy Sutton | Nurse Practitioner | 1901 Belmont Dr, Tyler, TX 75701-4338 | 2019-08-05 |
| 1063067577 | Elnora King | Nurse Practitioner | 1600 Rice Rd Apt 1117, Tyler, TX 75703-3308 | 2019-08-02 |
| 1851959472 | Tx Np Health, Pllc | Nurse Practitioner | 21755 Syrah Ln, Tyler, TX 75703-9274 | 2019-05-29 |
| 1114482569 | Carolyn Johnson | Nurse Practitioner | 13462 Hwy 110 N, Tyler, TX 75704-2444 | 2019-02-08 |
| 1720543556 | Kelsey Danielle Sheeley | Nurse Practitioner | 6770 Old Jacksonville Hwy Ste 103, Tyler, TX 75703-0576 | 2019-02-06 |
| 1790257392 | Tiffany Yvette Gardner | Nurse Practitioner | 301 Fm 757, Tyler, TX 75705-4503 | 2018-12-20 |
| 1174023352 | Jonathan Brice King | Nurse Practitioner | 721 Clinic Dr # A, Tyler, TX 75701-2043 | 2018-02-14 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.