Active NPI
Mary Grace Evasco Vinson, FNP
- Adult Health Nurse Practitioner
- Crestview, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- ARNP11026114
- Practice address
- 302 E James Lee Blvd
Crestview, FL 32539-2827 - Phone
- (302) 325-3928
- NPI assigned
- May 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 11026114 | FL | |
| Acute Care Nurse Practitioner | 363LA2100X | ARNP11026114 | FL | |
| Community Health Nurse Practitioner | 363LC1500X | ARNP11026114 | FL | |
| Family Nurse Practitioner | 363LF0000X | ARNP11026114 | FL | |
| Adult Health Nurse Practitioner | 363LA2200X | ARNP11026114 | FL | Primary |
Addresses
Primary practice location
302 E James Lee Blvd
Crestview, FL 32539-2827
Mailing address
302 E James Lee Blvd
Crestview, FL 32539-2827
Phone (866) 389-2727
Other names 1
- Grace Vinson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
302 E James Lee Blvd
Crestview, FL 32539-2827
Phone (866) 389-2727
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11026114 | FL | MD | Nurse Practitioner |
| ARNP11026114 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theoria Medical | Nurse Practitioner | Current | Accepting new patients |
| Minuteclinic LLC | Nurse Practitioner | Current | Accepting new patients |
| Theoria Medical | Nurse Practitioner | Past | Accepting new patients |
Locations
302 E James Lee Blvd
Crestview, FL 32539
Phone (850) 682-1002
701 Lake Port Blvd
Leesburg, FL 34748
Phone (352) 728-3366
121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380
12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473
1053 John Sims Pkwy E
Niceville, FL 32578
Phone (850) 768-0213
8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840
7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
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 and National Provider Directory roles.
-
dba Theoria Primary Care
- Internal Medicine Physician
- Brighton, MI
- NPI 1164186946
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758585600000",
"number": "1083303481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 E JAMES LEE BLVD",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325392827",
"telephone_number": "866-389-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 E JAMES LEE BLVD",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325392827",
"telephone_number": "302-325-3928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINSON",
"first_name": "MARY GRACE",
"middle_name": "EVASCO",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-02",
"last_updated": "2025-09-23",
"certification_date": "2025-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "11026114",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "FL",
"license": "ARNP11026114",
"primary": false
},
{
"code": "363LC1500X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Community Health",
"state": "FL",
"license": "ARNP11026114",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP11026114",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "ARNP11026114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GRACE",
"last_name": "VINSON",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.