Active NPI
Christy Grace Health Center Inc
- Nursing Care Agency
- Round Rock, TX
National Provider Identifier
1457727182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363595501 | Medicaid | TX |
National Provider Directory
National Provider DirectoryLocations
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.