Active NPI
Jacob Aaron Grady
- Registered Nurse
- Nixa, MO
National Provider Identifier
1437866522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2020016991
- Practice address
- 1239 W Bluegrass Rd
Nixa, MO 65714-8058 - Phone
- (417) 593-9801
- NPI assigned
- Oct 31, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2020016991 | MO | Primary |
Addresses
Primary practice location
1239 W Bluegrass Rd
Nixa, MO 65714-8058
Mailing address
1239 W Bluegrass Rd
Nixa, MO 65714-8058
Phone (417) 593-9801
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020016991 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1437866522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1239 W BLUEGRASS RD",
"city": "NIXA",
"state": "MO",
"postal_code": "657148058",
"telephone_number": "417-593-9801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1239 W BLUEGRASS RD",
"city": "NIXA",
"state": "MO",
"postal_code": "657148058",
"telephone_number": "417-593-9801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "JACOB",
"middle_name": "AARON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-31",
"last_updated": "2022-10-31",
"certification_date": "2022-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2020016991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.