Grace Ballew, RD, LD
Individual provider Active NPI Registered Dietitian · Tulsa, OK
NPI 1346790300 · NPPES record last updated Jan 14, 2021
Key facts
- NPI
- 1346790300
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2088 (OK)
- Practice address
- 12697 E 51St St
Tulsa, OK 74146-6236 - Phone
- (918) 505-3201
- Fax
- (919) 505-3258
- NPI assigned
- Oct 13, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86020939 | OK | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86020939 | OK | |
| Registered Dietitian | 133V00000X | 2088 | OK | Yes |
Addresses
Primary practice location
12697 E 51St St
Tulsa, OK 74146-6236
Mailing address
9386 S 278TH East Ave
Broken Arrow, OK 74014-4305
Phone (405) 334-2101
Other providers in Tulsa, OK
- Margaretta Ballard
- Mary Michelle Ballard
- Stephen Notfound Ballard Sr.
- Sterling Kortez Ballard
- Dawn Marie Ballew
- Laura Renee Ballew
- Megan Sunshine Ballew
- Jessica Michelle Ballinger
- Tracy Lee Ballinger
- Kassandre S Balocca
All providers in Tulsa, OK · Registered Dietitian in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.