Organization Active NPI

Gracefully Renewed

  • Family Medicine Physician
  • Harts, WV
National Provider Identifier
1043121205
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRACEFULLY RENEWED
Practice address
74 Alford BR
Harts, WV 25524-8700
Phone
(304) 305-3662
NPI assigned
Sep 16, 2026
Last updated
Sep 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Chassity R Kirk, APRN,FNP-BC
Title
Nurse Practitioner
Phone
(304) 305-3662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

74 Alford BR
Harts, WV 25524-8700

Mailing address

74 Alford BR
Harts, WV 25524-8700
Phone (304) 305-3662

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1043121205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 ALFORD BR",
            "city": "HARTS",
            "state": "WV",
            "postal_code": "255248700",
            "telephone_number": "304-305-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 ALFORD BR",
            "city": "HARTS",
            "state": "WV",
            "postal_code": "255248700",
            "telephone_number": "304-305-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFULLY RENEWED",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "CHASSITY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "304-305-3662",
        "authorized_official_credential": "APRN,FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harts, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.