Active NPI
Jessie Grace
- Nurse Practitioner
- Germantown, TN
National Provider Identifier
1043725757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 0000023224
- Practice address
- 7796 Wolf Trail CV
Germantown, TN 38138 - Phone
- (901) 751-0939
- NPI assigned
- Dec 5, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0000023224 | TN | Primary |
Addresses
Primary practice location
7796 Wolf Trail CV
Germantown, TN 38138
Mailing address
4196 Oak Rd
Memphis, TN 38135-1872
Phone (901) 512-3966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000023224 | TN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531699200000",
"number": "1043725757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4196 OAK RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381351872",
"telephone_number": "901-512-3966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7796 WOLF TRAIL CV",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "38138",
"telephone_number": "901-751-0939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "JESSIE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-05",
"last_updated": "2018-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TN",
"license": "0000023224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.