Individual provider Active NPI

Grace Sri

  • Personal Care Attendant
  • Henderson, NV
National Provider Identifier
1104300870
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
2572 Misty Olive Ave
Henderson, NV 89052-2933
Phone
(702) 235-9673
NPI assigned
Sep 19, 2018
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X NU Primary

Addresses

Primary practice location

2572 Misty Olive Ave
Henderson, NV 89052-2933

Mailing address

6128 W Sahara Ave
Las Vegas, NV 89146-3051
Phone (702) 598-2048

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

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1104300870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463051",
            "telephone_number": "702-598-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2572 MISTY OLIVE AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522933",
            "telephone_number": "702-235-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRI",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.