Individual provider Active NPI

Gracy Jilson, WHCNP

  • Women's Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1225194764
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
578383 Issued in TX
Practice address
5201 Harry Hines Blvd
Wish Tubal Clinic
Dallas, TX 75235-7708
Phone
(214) 590-5306
Fax
(214) 590-2798
NPI assigned
Dec 29, 2006
Last updated
Apr 22, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 578383 TX Primary

Addresses

Primary practice location

5201 Harry Hines Blvd
Wish Tubal Clinic
Dallas, TX 75235-7708

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Other identifiers 10

IdentifierTypeStateIssuer
195875302MedicaidTX
195875304MedicaidTX
195875301MedicaidTX
195875305MedicaidTX
195875307MedicaidTX
195875309MedicaidTX
195875310MedicaidTX
195875308MedicaidTX
195875303MedicaidTX
195875306MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210603002685 TX Practitioner - Nurse Practitioner 3375736309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.1 of 100Reported as group
Quality
88.97
Promoting interoperability
79
Improvement activities
40
Cost
83.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
578383TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rejoice Health LLC Current Accepting new patients
Dallas County Hospital District Women's Health CurrentSince Feb 18, 2021 Accepting new patients
Dallas County Hospital District Women's Health CurrentSince Feb 18, 2021 Accepting new patients
Dallas County Hospital District Women's Health Current Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: gjilson11101@direct.phhs.org

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1225194764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "address_2": "WISH TUBAL CLINIC",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-590-5306",
            "fax_number": "214-590-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JILSON",
        "first_name": "GRACY",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "578383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875304",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875305",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875307",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875309",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875310",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875308",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195875306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.