Individual provider Active NPI

Gradie Tshikuna Mbiya

  • Driver
  • Franklin, OH
National Provider Identifier
1104776285
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
3966 Wilson Farms Blvd
Franklin, OH 45005-3599
Phone
(704) 713-0286
NPI assigned
Jan 29, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X OH Primary

Addresses

Primary practice location

3966 Wilson Farms Blvd
Franklin, OH 45005-3599

Mailing address

3966 Wilson Farms Blvd
Franklin, OH 45005-3599
Phone (704) 713-0286

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": "1769644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1104776285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3966 WILSON FARMS BLVD",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450053599",
            "telephone_number": "704-713-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3966 WILSON FARMS BLVD",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450053599",
            "telephone_number": "704-713-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBIYA",
        "first_name": "GRADIE",
        "middle_name": "TSHIKUNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, OH

Sources for this page

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