Individual provider Active NPI

Grace Stanley, M.D.

  • Family Medicine Physician
  • Round Rock, TX
National Provider Identifier
1255583563
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N9413 Issued in TX
Practice address
425 University Blvd
Round Rock, TX 78665-1053
Phone
(512) 509-0200
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N9413 TX Primary

Addresses

Primary practice location

425 University Blvd
Round Rock, TX 78665-1053

Mailing address

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

Other practice location 1

610 E Jefferson Blvd
110
Dallas, TX 75203-2750
Phone (214) 222-9115

Other practice location 2

610 E Jefferson Blvd
110
Dallas, TX 75203-2750
Phone (214) 222-9115

Other identifiers 1

IdentifierTypeStateIssuer
N9413OtherTXTEXAS MEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180208000779 TX Order and Referring Only - Family PracticePractitioner - Family Practice 8325211295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carefirst Medical Group Family Medicine PastSince Oct 1, 2018 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1255583563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651053",
            "telephone_number": "512-509-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651053",
            "telephone_number": "512-509-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 E Jefferson Blvd",
            "address_2": "110",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752032750",
            "country_code": "US",
            "telephone_number": "214-222-9115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 E Jefferson Blvd",
            "address_2": "110",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752032750",
            "country_code": "US",
            "telephone_number": "214-222-9115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "GRACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N9413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "N9413",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.