Individual provider Active NPI

Grace A Bryant, PA-C

  • Physician Assistant
  • Evansville, IN
National Provider Identifier
1063991008
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
99088137A Issued in IN
Practice address
100 S Rosenberger Ave Ste A200
Evansville, IN 47712-6505
Phone
(812) 401-0500
NPI assigned
Aug 10, 2018
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 99088137A IN Primary

Addresses

Primary practice location

100 S Rosenberger Ave Ste A200
Evansville, IN 47712-6505

Mailing address

100 S Rosenberger Ave Ste A200
Evansville, IN 47712-6505

Other practice location 1

2085 Acorn Blvd
Franklin, IN 46131-7306
Phone (317) 346-2273

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address grace.wempe.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190613000919 IN Practitioner - Physician Assistant 3274866835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

100 S Rosenberger Ave
Suite A200
Evansville, IN 47712-6505
Phone (812) 485-1550

801 Saint Marys Dr
505E
Evansville, IN 47714-0528
Phone (812) 491-3236

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
99088137AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Medical Group, LLC Physician Assistant CurrentSince Dec 16, 2019 Accepting new patients
Primary Physicians Network LLC Physician Assistant Current Accepting new patients
St. Mary's Health, Inc Past Accepting new patients

Locations

100 S Rosenberger Ave
Ste A200
Evansville, IN 47712
Phone (812) 401-0500

100 S Rosenberger Ave
Ste B200
Evansville, IN 47712
Phone (812) 433-2000

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

Interoperability endpoints

  • Direct secure messaging: grace.wempe.1@7598.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1063991008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S ROSENBERGER AVE STE A200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477126505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ROSENBERGER AVE STE A200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477126505",
            "telephone_number": "812-401-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2085 Acorn Blvd",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "IN",
            "postal_code": "461317306",
            "country_code": "US",
            "telephone_number": "317-346-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "GRACE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "99088137A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grace.wempe.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "100 S Rosenberger Ave Ste A200",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477126505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.