Yolanda Grady

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4360 Issued in MS

Practice address

340 Desoto Avenue Ext
Clarksdale, MS 38614-2814

Phone

(662) 627-3468

NPI assigned

Mar 24, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1356091318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 13TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393015315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 DESOTO AVENUE EXT",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386142814",
            "telephone_number": "662-627-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "YOLANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "4360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bronwynn Claire Gist, RHD
• Caleb Tyler Gooch, PHARMD
• Billie M Goodman, M.A., CCC-A
• Grace Christian Counseling Center of Clarksdale
• Teressa L Grace, N/A
• April Green, ATC
• Alecia Greer, CNA
• Frances Parker Griffin, MSW
• Regina Denise Groner, NURSE PRACTITIONER
• Guardian Angel Adult Day Services LLC

• Physical Therapy Assistant in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Physical Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.