Graceful Wellness and Med Spa, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GRACEFUL WELLNESS AND MED SPA, LLC

Practice address

11030 Oakmont St Ste 100
Overland Park, KS 66210-1120

Phone

(913) 608-9450

NPI assigned

Dec 3, 2024

Last updated

Dec 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Nichols, APRNNPI 1427261247

Title

Ceo

Phone

(913) 608-9450

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Nichols, ARNP

  • Nurse Practitioner
  • Overland Park, KS
  • NPI 1427261247
  NPD Authorized official

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1164248332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11030 OAKMONT ST STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101120",
            "telephone_number": "913-608-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11030 OAKMONT ST STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101120",
            "telephone_number": "913-608-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL WELLNESS AND MED SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "913-608-9450",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Cottage Senior Care LLC
• Grace Dental Group, LLC
• Grace Dental, P.a.
• Grace Family Acupuncture LLC (Yang Gong MBR)
• Grace Rehabilitation of Overland Park, LLC
• Edith Gracius, APRN, PMHNP-BC
• Stephen C Gradwohl, D.C.
• Tracy Jane Graebener, FNP
• Donna Marie Graessle, DO
• John Alex Gragg

• Clinic/Center in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.