Active NPI
Gracie Nichols
- Women's Health Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1154835858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- R230509
- Practice address
- 22 S Greene St
Baltimore, MD 21201-1544 - Phone
- (410) 328-5925
- NPI assigned
- Nov 17, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | R230509 | MD | Primary |
Addresses
Primary practice location
22 S Greene St
Baltimore, MD 21201-1544
Mailing address
22 S Greene St # N7E16
Baltimore, MD 21201-1544
Phone (410) 328-5925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180703000633 | MD | Order and Referring Only - Nurse Practitioner | 3971859067 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- gnichols506879@direct.umm.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645401600000",
"number": "1154835858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 S GREENE ST # N7E16",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011544",
"telephone_number": "410-328-5925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 S GREENE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011544",
"telephone_number": "410-328-5925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "GRACIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-17",
"last_updated": "2022-02-21",
"certification_date": "2022-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MD",
"license": "R230509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.