Active NPI
Sally Maloney Grace, ARNP
- Nurse Practitioner
- Pensacola, FL
National Provider Identifier
1366614745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP1025132
- Practice address
- 5149 N 9TH Ave
Suite 254
Pensacola, FL 32504-8756 - Phone
- (850) 416-7619
- Fax
- (850) 416-7753
- NPI assigned
- Mar 26, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP1025132 | FL | Primary |
Addresses
Primary practice location
5149 N 9TH Ave
Suite 254
Pensacola, FL 32504-8756
Mailing address
PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 416-7619
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y124G | Other | FL | BLUE SHIELD |
| 309118000 | Other | FL | MEDICAID |
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413763200000",
"number": "1366614745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2699",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325132699",
"telephone_number": "850-416-7619",
"fax_number": "850-416-7753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5149 N 9TH AVE",
"address_2": "SUITE 254",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325048756",
"telephone_number": "850-416-7619",
"fax_number": "850-416-7753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "SALLY",
"middle_name": "MALONEY",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-26",
"last_updated": "2014-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP1025132",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "Y124G",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "309118000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.