Individual provider Active NPI

Rachel Lauren Grady, NP-C

  • Nurse Practitioner
  • Palm Bay, FL
National Provider Identifier
1497644397
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11040521 Issued in FL
Practice address
1192 Canfield Cir SE
Palm Bay, FL 32909-1436
Phone
(423) 790-6971
NPI assigned
Jul 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11040521 FL Primary

Addresses

Primary practice location

1192 Canfield Cir SE
Palm Bay, FL 32909-1436

Mailing address

1192 Canfield Cir SE
Palm Bay, FL 32909-1436
Phone (423) 790-6971

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

LicenseStateTypeSpecialty
11040521FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1497644397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1192 CANFIELD CIR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329091436",
            "telephone_number": "423-790-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1192 CANFIELD CIR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329091436",
            "telephone_number": "423-790-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "RACHEL",
        "middle_name": "LAUREN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11040521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.