Eagle Mountain Healthcare LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

EAGLE MOUNTAIN HEALTHCARE LLC

Practice address

807 Southeast Pkwy
Azle, TX 76020-3658

Phone

(817) 661-8197

NPI assigned

Feb 10, 2023

Organization subpart

No

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

Authorized official

Name

Heather Grayson, AGNPNPI 1750879649

Title

Nurse Practitioner/Owner

Phone

(817) 661-8197

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Grayson, AGNP

  • Adult Health Nurse Practitioner
  • Azle, TX
  • NPI 1750879649

  Adult Health, TX

  Medicare reassignment Care Compare group NPD Authorized official
• Heather Fulton

  • Family Nurse Practitioner
  • Azle, TX
  • NPI 1912653015

  TX

  Medicare reassignment Care Compare group NPD
• Melissa Bell, FNP

  • Family Nurse Practitioner
  • Azle, TX
  • NPI 1659219483

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1508563578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 SOUTHEAST PKWY",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203658",
            "telephone_number": "817-661-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 SOUTHEAST PKWY",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203658",
            "telephone_number": "817-661-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MOUNTAIN HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-10",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "GRAYSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "817-661-8197",
        "authorized_official_credential": "AGNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Driscoll Surgical, LLC
• Stacie L Driscoll, CSFA
• Jennifer Dubose
• Julia A Dunaway, LCSW, BCD
• Jami Dykes
• Eagle Mountian Family Dental, PC
• Elizabeth J Edmonson
• Educare Community Living Limited Partnership
• Educare Community Living Limited Partnership
• Educare Community Living Limited Partnership

• All providers in Azle, TX
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.