Individual provider Active NPI

Amy Katheryn Grace, F.N.P

  • Family Nurse Practitioner
  • Astoria, OR
National Provider Identifier
1073948923
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201505838 Issued in OR
Practice address
2111 Exchange St
Astoria, OR 97103-3329
Phone
(503) 325-4321
NPI assigned
Sep 11, 2013
Last updated
Feb 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201505838 OR Primary

Addresses

Primary practice location

2111 Exchange St
Astoria, OR 97103-3329

Mailing address

PO Box 491
Cannon Beach, OR 97110-0491
Phone (307) 760-4262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20180314001625 WA Practitioner - Nurse Practitioner 7315177938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1274 7TH St
Port Townsend, WA 98368-2404

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201505838ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 CurrentSince Mar 1, 2018 Accepting new patients
Jefferson County Public Hospital District No 2 Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Jefferson County Public Hospital District No 2 Past Accepting new patients
Jefferson County Public Hospital District No 2 Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

1010 Sheridan St
Ste 101
Port Townsend, WA 98368
Phone (360) 379-8031

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

1274 7th St
#A
Port Townsend, WA 98368
Phone (360) 385-2204

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

834 Sheridan St
#B
Port Townsend, WA 98368
Phone (360) 385-2204

915 Sheridan St
Port Townsend, WA 98368
Phone (360) 379-8031

934 Sheridan St
Port Townsend, WA 98368
Phone (360) 385-5330

Organizations & group practices 6

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": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1073948923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491",
            "city": "CANNON BEACH",
            "state": "OR",
            "postal_code": "971100491",
            "telephone_number": "307-760-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 EXCHANGE ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033329",
            "telephone_number": "503-325-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "AMY",
        "middle_name": "KATHERYN",
        "credential": "F.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201505838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.