Grace Mountain Health & Wellness LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

GRACE MOUNTAIN HEALTH & WELLNESS LLC

Practice address

107 Moores Canyon Rd Ste 4
Trinidad, CO 81082-8554

Phone

(719) 752-0250

Fax

(719) 435-9807

NPI assigned

Nov 4, 2025

Last updated

Nov 4, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey W Lewis

Title

Co-Owner

Phone

(304) 676-9947

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793750400000",
    "number": "1023987229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MOORES CANYON RD STE 4",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810828554",
            "telephone_number": "719-752-0250",
            "fax_number": "719-435-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MOORES CANYON RD STE 4",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810828554",
            "telephone_number": "719-752-0250",
            "fax_number": "719-435-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MOUNTAIN HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-04",
        "last_updated": "2026-11-04",
        "certification_date": "2026-11-04",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "304-676-9947"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikolai Gammage, PTA
• Vincent A Gatti Sr., ACA0008058 08312023
• Lana Geier, NP
• Gerald a. Cichocki, M.D., PC (Trinidad Urology Center)
• Thomas Perry Goodell, M.D.
• Shandell Graves, L.M.T.
• William Brian Greiser, MD
• Holly Gutierrez
• George H Hagen, O.D.
• Marquita Hahn, FNP-C

• Nurse Practitioner in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2026; 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.