Grace Healthcare Group PLLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

GRACE HEALTHCARE GROUP PLLC

Practice address

1721 Main St
White Pine, TN 37890-3303

Phone

(865) 761-0103

Fax

(865) 761-0272

NPI assigned

Feb 20, 2020

Last updated

Feb 20, 2020By 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

Ursula M Treadaway, PACNPI 1104364918

Title

Pac/Owner

Phone

(865) 761-0103

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21743/brand/1/csg/1/fhir/r4

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.

• Ursula Treadaway, PA-C

  • Physician Assistant
  • Kodak, TN
  • NPI 1104364918
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1245863901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74",
            "city": "WHITE PINE",
            "state": "TN",
            "postal_code": "378900074",
            "telephone_number": "865-761-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 MAIN ST",
            "city": "WHITE PINE",
            "state": "TN",
            "postal_code": "378903303",
            "telephone_number": "865-761-0103",
            "fax_number": "865-761-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HEALTHCARE GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "TREADAWAY",
        "authorized_official_first_name": "URSULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PAC/OWNER",
        "authorized_official_telephone_number": "865-761-0103",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Nicole Chastain, FNP-BC
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• Mark Corum
• Dr. Kimberly Parks OD PLLC
• Jennifer S Eisenhower, F.N.P.
• Healthstar Physicians, PC
• Carrie Lynn Henry
• Julie D Hubbard, FNP-C
• Hurley Family Dentistry
• Joseph Clinton Hurley, DDS

• Medical Physician Assistant in White Pine, TN
• Providers in White Pine, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.