Individual provider Active NPI

Charlene De Grassi, FNP-C

  • Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1306330444
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
220059 Issued in MT
Practice address
2673 Palmer St Ste 201
Missoula, MT 59808-1783
Phone
(406) 728-8848
Fax
(406) 549-8970
NPI assigned
Jun 21, 2018
Last updated
Jul 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 220059 MT Primary

Addresses

Primary practice location

2673 Palmer St Ste 201
Missoula, MT 59808-1783

Mailing address

2673 Palmer St Ste 201
Missoula, MT 59808-1783
Phone (406) 728-8848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180921003153 CA Practitioner - Nurse Practitioner 4486905999 Reassigns benefits to 1 organization
I20240823003253 MT Practitioner - Nurse Practitioner 4486905999 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Home Care, Inc Multi-Specialty CurrentSince Jun 26, 2024 Accepting new patients
Beaver Medical Group P C Multi-Specialty CurrentSince Jul 16, 2018 Accepting new patients
Beaver Medical Group P C Multi-Specialty CurrentSince Jul 16, 2018 Accepting new patients
Pih Health Whittier Hospital Multi-Specialty Past Accepting new patients
Beaver Medical Group P C Multi-Specialty Past Accepting new patients

Locations

7000 Boulder Ave
Highland, CA 92346

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102

2 W Fern Ave
Redlands, CA 92373
Phone (909) 786-0725

2 W Fern Ave
#1112
Redlands, CA 92373

2673 Palmer St
Ste 201
Missoula, MT 59808
Phone (406) 327-3646

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1306330444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2673 PALMER ST STE 201",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081783",
            "telephone_number": "406-728-8848",
            "fax_number": "406-549-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2673 PALMER ST STE 201",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081783",
            "telephone_number": "406-728-8848",
            "fax_number": "406-549-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GRASSI",
        "first_name": "CHARLENE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "220059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.