Grace Medical Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GRACE MEDICAL INC.

Practice address

11240 Stillwater Blvd N
Lake Elmo, MN 55042-9321

Phone

(866) 514-7223

NPI assigned

Jun 27, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Sandi Mattox

Title

Owner

Phone

(651) 430-8184

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Grace Medical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grace Medical Inc.

  • Durable Medical Equipment & Medical Supplies
  • Stillwater, MN
  • NPI 1629364799
  NPD tax ID

Locations

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1205356573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 2ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824059",
            "telephone_number": "651-430-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 STILLWATER BLVD N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550429321",
            "telephone_number": "866-514-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "MATTOX",
        "authorized_official_first_name": "SANDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-430-8184",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aryam Gebreamlak
• Temesgen Gessisa
• Gilbert K Ghong, LPCC
• Ellen Giere, C.F.N.P.
• Dennis James Grabowski, DDS
• Richard Craig Graham, M.D.
• Coleen Maclean Groen, MSW, LCSW
• Susan K. Grothe
• Group Health, Inc.
• Group Health, Inc.

• Durable Medical Equipment & Medical Supplies in Lake Elmo, MN
• Providers in Lake Elmo, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.