Organization Active NPI

Christy Grace Health Center Inc

  • Nursing Care Agency
  • Round Rock, TX
National Provider Identifier
1457727182
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
CHRISTY GRACE HEALTH CENTER INC
Practice address
2000 S Ih 35 Ste Q8C
Round Rock, TX 78681-6917
Phone
(512) 586-9963
Fax
(512) 271-8358
NPI assigned
Aug 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Authorized official

Name
Mr. Oyen Joshua Borngt Iyamu
Title
Ceo
Phone
(512) 586-9963

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Nursing Care Agency 251J00000X Primary

Addresses

Primary practice location

2000 S Ih 35 Ste Q8C
Round Rock, TX 78681-6917

Mailing address

2000 S Ih 35 Ste Q8C
Round Rock, TX 78681-6917
Phone (512) 586-9963

Other identifiers 1

IdentifierTypeStateIssuer
363595501MedicaidTX

National Provider Directory

National Provider Directory

Locations

2000 S Interstate 35
Ste Q8C
Round Rock, TX 78681
Phone (512) 576-3221

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1457727182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S IH 35 STE Q8C",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786816917",
            "telephone_number": "512-586-9963",
            "fax_number": "512-271-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S IH 35 STE Q8C",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786816917",
            "telephone_number": "512-586-9963",
            "fax_number": "512-271-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTY GRACE HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "IYAMU",
        "authorized_official_first_name": "OYEN",
        "authorized_official_middle_name": "JOSHUA BORNGT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-586-9963",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363595501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.