Amazing Grace Health, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

AMAZING GRACE HEALTH, LLC

Practice address

625 Snelling Ave N Ste a
Saint Paul, MN 55104-5585

Phone

(952) 288-9921

NPI assigned

Jan 10, 2020

Organization subpart

No

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

Authorized official

Name

Victor Davis

Title

Co-Owner/Nurse Practitioner

Phone

(952) 288-9921

Specialties & licenses 2

Addresses

Electronic endpoints 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22592/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1568002160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N STE A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045585",
            "telephone_number": "763-381-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N STE A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045585",
            "telephone_number": "952-288-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "CO-OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "952-288-9921"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "davisvic",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "625 Snelling Ave N Ste A",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551045585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bobby R Amagan, MASSAGE THERAPIST
• Patricia Chinnaya Amajuoyi, RN
• Susan Amann, MSW, LICSW
• Solomon Amare
• Miranda Amaris, MIRANDA
• Amazing Health L. L. C.
• Joseph Paul Amberg, MD
• Paul David Amble, DDS
• Terese Marie Amble, PSY.D.
• Deanna Lynne Amborn, CCC-SLP, MST

• Family Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Family Nurse Practitioner in Minnesota

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

Verify at the official NPI Registry.