NPIMap

Individual provider Active NPI

Kathryn L Grace, PA-C

  • Physician Assistant
  • Halfway, OR
National Provider Identifier
1467575639
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-00542 Issued in OR
Practice address
218 N. Pine Street
Halfway, OR 97834
Phone
(417) 425-0235
Fax
(541) 742-7210
NPI assigned
Apr 10, 2007
Last updated
May 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-00542 OR Primary

Addresses

Primary practice location

218 N. Pine Street
Halfway, OR 97834

Mailing address

PO Box 647
Halfway, OR 97834-0647
Phone (541) 742-5023

Other identifiers 1

IdentifierTypeStateIssuer
500648623MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120817000205 OR Practitioner - Physician Assistant 4183675952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

218 N Pine St
Halfway, OR 97834-2506
Phone (541) 742-5023

PO Box
Halfway, OR 97834

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-00542ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Eagle Health Planning Committee CurrentSince Mar 22, 2021 Accepting new patients
Elkhorn Chiropractic Inc Past Accepting new patients
Robert J Bachman P T PC Past Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kathryn.grace.1@24857.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1467575639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 647",
            "city": "HALFWAY",
            "state": "OR",
            "postal_code": "978340647",
            "telephone_number": "541-742-5023",
            "fax_number": "541-742-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N. PINE STREET",
            "city": "HALFWAY",
            "state": "OR",
            "postal_code": "97834",
            "telephone_number": "417-425-0235",
            "fax_number": "541-742-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2021-05-17",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA-00542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500648623",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Halfway, OR

Sources for this page

Verify at the official NPI Registry.