Active NPI
Jamie M Grace
- In Home Supportive Care Agency
- Roanoke, VA
National Provider Identifier
1558095240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 634 Applewood St NE
Roanoke, VA 24019-5603 - Phone
- (540) 795-5175
- NPI assigned
- Jul 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary | ||
| Assisted Living Facility (Mental Illness) | 3104A0625X | |||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X |
Addresses
Primary practice location
634 Applewood St NE
Roanoke, VA 24019-5603
Mailing address
PO Box 12504
Roanoke, VA 24026-2504
Phone (540) 795-5175
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657497600000",
"number": "1558095240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12504",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240262504",
"telephone_number": "540-795-5175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "634 APPLEWOOD ST NE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240195603",
"telephone_number": "540-795-5175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "JAMIE",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-11",
"last_updated": "2022-07-11",
"certification_date": "2022-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.