NPIMap

Individual provider Active NPI

Grace Taylor, RN, MA, CHC

  • Nutritionist
  • Clinton, MD
National Provider Identifier
1104174101
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
59393011 Issued in NY
Practice address
8103 Fawn CT
Clinton, MD 20735-1947
Phone
(240) 388-5396
NPI assigned
Aug 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 59393011 NY Primary

Addresses

Primary practice location

8103 Fawn CT
Clinton, MD 20735-1947

Mailing address

8103 Fawn CT
Clinton, MD 20735-1947
Phone (240) 388-5396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts, Registered Nurse

State licenses

LicenseStateTypeSpecialty
59393011NYMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Holistic Care LLC Current Accepting new patients
Infinite Holistic Health LLC Nutritionist Current Accepting new patients
Restorative Health Care LLC Nutritionist Current Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1104174101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8103 FAWN CT",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351947",
            "telephone_number": "240-388-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8103 FAWN CT",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351947",
            "telephone_number": "240-388-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "GRACE",
        "credential": "RN, MA, CHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-22",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "59393011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.