Graceridge Inc

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Legal business name

GRACERIDGE INC

Practice address

3909 Hill Dr
Jonesboro, AR 72401-8850

Phone

(870) 935-5961

NPI assigned

Apr 4, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Kelly Grojean

Title

President

Phone

(870) 530-9706

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1194287425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 CHESTNUT ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013801",
            "telephone_number": "870-530-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 HILL DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724018850",
            "telephone_number": "870-935-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACERIDGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "GROJEAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-530-9706",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223545732",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mandy Dawn Gordon, APN
• Rotunda Gorman, MSW
• Katie Gosch
• Charles Gothard, APRN
• Ashwini Gotimukul, MD
• Carla Graddy, OTD OTR/L
• April Grady, APRN
• Ashli Grady
• Haley Grady
• Allison Renee Gragg, APRN

• Attendant Care Provider in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Attendant Care Provider in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.