Tabatha Grace

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

254322 Issued in AZ

Practice address

1500 S White Mountain Rd BLDG 3
Show Low, AZ 85901-7111

Phone

(928) 532-5838

NPI assigned

Mar 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Changepoint Integrated HealthGroup PAC ID 8123004587, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDIDBD/Endpoint/HDIDBD

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.

• Changepoint Integrated Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holbrook, AZ
  • NPI 1205877610
  Medicare reassignment Care Compare group
• Changepoint Integrated Health

  • Community/Behavioral Health Agency
  • Show Low, AZ
  • NPI 1518202100
  NPD (past)

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

• Summit Healthcare Association

  dba Summit Healthcare Oncology Center

  • Oncology Clinic/Center
  • Show Low, AZ
  • NPI 1083736128

  Hospital

  Care Compare affiliation
• Summit Healthcare Association

  dba Summit Healthcare Regional Medical Center

  • Rural Acute Care Hospital
  • Show Low, AZ
  • NPI 1144209271
  Care Compare affiliation
• Summit Healthcare Medical Associates

  dba Family Medicine at Bison Ranch

  • Rural Health Clinic/Center
  • Overgaard, AZ
  • NPI 1770700767

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1104402338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S MAIN ST",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "859375661",
            "telephone_number": "928-536-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S WHITE MOUNTAIN RD BLDG 3",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017111",
            "telephone_number": "928-532-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "TABATHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-18",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "254322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth A Giles, MD
• William Gonzalez, L.C.S.W.
• Brian William Goodman, DO
• Katrine Gordon, PT
• Steven F Gorman-Hackstadt, RPH
• Guardian Flight LLC
• Guardian Flight LLC
• Guardian Flight LLC
• Katie Habgood, LPC
• Raedene Ann Hageman, FNP-C

• Family Nurse Practitioner in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.

Verify at the official NPI Registry.