Individual provider Active NPI

Grace A Lavalley, DNP

  • Acute Care Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1497272397
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP61512075 Issued in WA
Practice address
1802 Yakima Ave Ste 307
Tacoma, WA 98405-5305
Phone
(253) 627-1244
Fax
(253) 627-6576
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN269757 MA
Gerontology Nurse Practitioner 363LG0600X AP61512075 WA
Acute Care Nurse Practitioner 363LA2100X AP61512075 WA Primary

Addresses

Primary practice location

1802 Yakima Ave Ste 307
Tacoma, WA 98405-5305

Mailing address

1802 Yakima Ave Ste 307
Tacoma, WA 98405-5305
Phone (253) 627-1244

Other identifiers 1

IdentifierTypeStateIssuer
2284112MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address glavalley858975@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170901002364 MA Practitioner - Nurse Practitioner 4587937107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

40 Wright St
Palmer, MA 01069-1138
Phone (413) 284-5400

Hospital & facility affiliations

  • Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030
  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN269757MAMDAcute Care Nurse Practitioner
AP61512075WAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Baystate Medical Practices, Inc Acute Care CurrentSince Aug 25, 2017 Accepting new patients

Locations

40 Wright St
Palmer, MA 01069
Phone (413) 284-5210

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

3300 Main St
Ste 2
Springfield, MA 01107

1802 Yakima Ave
Ste 307
Tacoma, WA 98405
Phone (206) 627-1244

Interoperability endpoints

  • Direct secure messaging: glavalley858975@fhsce.catholichealth.net

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1497272397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 307",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 307",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLEY",
        "first_name": "GRACE",
        "middle_name": "A",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN269757",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61512075",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP61512075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2284112",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glavalley858975@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 Yakima Ave Ste 307",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.