Grace Syombua Jedidah

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1059626 Issued in TX

Practice address

539 W Commerce St # 3213
Dallas, TX 75208-1953

Phone

(682) 593-0477

Fax

(682) 593-0477

NPI assigned

Jun 18, 2022

Sex

Female

Sole proprietor

No

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

Enrolled in TX

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindcare Solutions of Texas, P.a.Group PAC ID 5597173088, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Mindcare Solutions of Texas PA

  • Psychiatry Physician
  • Austin, TX
  • NPI 1396290730
  Medicare reassignment Care Compare group NPD
• Tumaini Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Irving, TX
  • NPI 1942014972
  Medicare reassignment NPD Authorized official
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  TX

  Medicare reassignment NPD
• In Touch Psychiatry Consultants & Family Medicine, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mansfield, TX
  • NPI 1275005456
  NPD (past)
• Wellness Point Psychiatry Consultants, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mansfield, TX
  • NPI 1891266128
  NPD (past)

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

{
    "created_epoch": "1655510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1386375665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 W COMMERCE ST # 3213",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752081953",
            "telephone_number": "682-593-0477",
            "fax_number": "682-593-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 W COMMERCE ST # 3213",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752081953",
            "telephone_number": "682-593-0477",
            "fax_number": "682-593-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDIDAH",
        "first_name": "GRACE",
        "middle_name": "SYOMBUA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-18",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1059626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Suhail Jebain, MD
• Hazel Patricia Jebaraj
• Oluleke S Jeboda, D.M.D,
• Michael Scot Jebsen, PT
• Jeda Ride Transportation LLC
• Sangyoon Jee, DMD
• Jeff Nance, MD, PA
• Jefferson First Assist PLLC
• Jefferson Orthodontics PLLC
• June Marie Jefferson-Randolph

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.