Active NPI
Grada Berry
- Military Health Care Provider
- Arlington, TX
National Provider Identifier
1346629094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- 016187
- Practice address
- 2520 Heather Brook LN Apt 804
Arlington, TX 76006-5177 - Phone
- (817) 633-0383
- Fax
- (817) 633-0084
- NPI assigned
- May 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 016187 | TX | Primary |
Addresses
Primary practice location
2520 Heather Brook LN Apt 804
Arlington, TX 76006-5177
Mailing address
PO Box 540574
Grand Prairie, TX 75054-0574
Phone (817) 633-0383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016187 | TX | MD | Military Health Care Provider |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silvertrail Ompassion Cae.LLC | Past | 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.
-
- Home Health Agency
- Arlington, TX
- NPI 1578943312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432771200000",
"number": "1346629094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 540574",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750540574",
"telephone_number": "817-633-0383",
"fax_number": "817-633-0084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2520 HEATHER BROOK LN APT 804",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760065177",
"telephone_number": "817-633-0383",
"fax_number": "817-633-0084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "GRADA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-28",
"last_updated": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "TX",
"license": "016187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.