Individual provider Active NPI

Gracie A Hines, FNP-BC

  • Nurse Practitioner
  • Greenville, MS
National Provider Identifier
1174112098
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904188 Issued in MS
Practice address
1032 Spruce St
Greenville, MS 38701-4319
Phone
(662) 347-1132
NPI assigned
Jan 14, 2021
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 904188 MS Primary

Addresses

Primary practice location

1032 Spruce St
Greenville, MS 38701-4319

Mailing address

PO Box 4696
Greenville, MS 38704-4696
Phone (662) 347-1132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220111000223 MS Practitioner - Nurse Practitioner 5092107771 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

1417 Hwy 1 S
Greenville, MS 38701-7141
Phone (662) 430-2451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 15, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Nurse Practitioner CurrentSince May 1, 2024 Accepting new patients
Upperline Healthcare, PC Nurse Practitioner CurrentSince Sep 15, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince May 1, 2024 Accepting new patients

Locations

2009 Highway 82 W
Greenwood, MS 38930
Phone (662) 595-4601

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Interoperability endpoints

  • Direct secure messaging: gracie.hines.1@23901.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JAGHDD/Endpoint/JAGHDD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1174112098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4696",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387044696",
            "telephone_number": "662-347-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 SPRUCE ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014319",
            "telephone_number": "662-347-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "GRACIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.