Active NPI
Luis Antonio Gracia, RN
- Registered Nurse
- Patillas, PR
National Provider Identifier
1124237235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- A001196
- Practice address
- 99 Guillermo Riefkohl St.
Patillas, PR 00723-0697 - Phone
- (787) 839-4320
- Fax
- (787) 271-0004
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | A001196 | PR | Primary |
Addresses
Primary practice location
99 Guillermo Riefkohl St.
Patillas, PR 00723-0697
Mailing address
99 Guillermo Riefkohl St.
Patillas, PR 00723-0697
Phone (787) 839-4320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A001196 | Other | PR | STATE LICENSE |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A001196 | PR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124237235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 GUILLERMO RIEFKOHL ST.",
"city": "PATILLAS",
"state": "PR",
"postal_code": "007230697",
"telephone_number": "787-839-4320",
"fax_number": "787-271-0004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 GUILLERMO RIEFKOHL ST.",
"city": "PATILLAS",
"state": "PR",
"postal_code": "007230697",
"telephone_number": "787-839-4320",
"fax_number": "787-271-0004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACIA",
"first_name": "LUIS",
"middle_name": "ANTONIO",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PR",
"license": "A001196",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "A001196",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Patillas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.