Individual provider Active NPI

Gretchen Renee Grant, NBHWC

  • Health & Wellness Coach
  • Glendale, AZ
National Provider Identifier
1104684661
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
R-08233030 Issued in AZ
Practice address
6269 W Rose Garden LN
Glendale, AZ 85308-6771
Phone
(520) 678-1101
NPI assigned
Mar 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness CoachGroup: 193400000X SINGLE SPECIALTY GROUP 171400000X R-08233030 AZ Primary

Addresses

Primary practice location

6269 W Rose Garden LN
Glendale, AZ 85308-6771

Mailing address

6269 W Rose Garden LN
Glendale, AZ 85308-6771
Phone (520) 678-1101

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

State licenses

LicenseStateTypeSpecialty
R-08233030AZMDHealth & Wellness Coach

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1104684661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6269 W ROSE GARDEN LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086771",
            "telephone_number": "520-678-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6269 W ROSE GARDEN LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086771",
            "telephone_number": "520-678-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "GRETCHEN",
        "middle_name": "RENEE",
        "credential": "NBHWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health & Wellness Coach",
            "state": "AZ",
            "license": "R-08233030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.