Individual provider Active NPI

Gracie Yvette Cooksey

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1417892803
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1231988 Issued in TX
Practice address
520 Madison Oak Dr
San Antonio, TX 78258-3912
Phone
(210) 297-4000
NPI assigned
Apr 21, 2026
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1231988 TX
Acute Care Nurse Practitioner 363LA2100X 1231988 TX Primary

Addresses

Primary practice location

520 Madison Oak Dr
San Antonio, TX 78258-3912

Mailing address

19500 Ih 10 W Stop 1-3030
San Antonio, TX 78257-9509
Phone (210) 955-6729

Other names 1

  • Gracie Yvette Gonzales Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1231988TXMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1417892803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 IH 10 W STOP 1-3030",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782579509",
            "telephone_number": "210-955-6729",
            "fax_number": "877-479-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MADISON OAK DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583912",
            "telephone_number": "210-297-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKSEY",
        "first_name": "GRACIE",
        "middle_name": "YVETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1231988",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1231988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACIE",
            "last_name": "GONZALES",
            "middle_name": "YVETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.