Active NPI
Christy Lea Grindle, CPNP-PC
- Pediatric Nurse Practitioner
- Gainesville, GA
National Provider Identifier
1568631224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- APRN-NP136984
- Practice address
- 725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834 - Phone
- (770) 535-3611
- Fax
- (770) 535-7092
- NPI assigned
- Feb 27, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | APRN-NP136984 | GA | Primary |
Addresses
Primary practice location
725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Mailing address
PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1122
Other practice location 1
4095 S Lee St
Buford, GA 30518-3647
Phone (770) 932-8519
Other practice location 2
4019 Executive Drive
Oakwood, GA 30566-3433
Phone (770) 533-6500
Other practice location 3
1270 Friendship Rd
Braselton, GA 30517-5608
Phone (678) 207-4200
Other practice location 4
155 Professional Dr
Baldwin, GA 30511-4000
Phone (706) 776-2368
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 441164 | Other | GA | WELLCARE |
| 787541872E | Medicaid | GA | |
| 441165 | Other | GA | WELLCARE |
| 787541872F | Medicaid | GA | |
| 441157 | Other | GA | WELLCARE |
| 441150 | Other | GA | WELLCARE |
| 787541872A | Medicaid | GA | |
| 787541872C | Medicaid | GA |
Other names 1
- Christy Lea Wallis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN-NP136984 | GA | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- christy.grindle@longstreetclinic.gadirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761782400000",
"number": "1568631224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 658",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305030658",
"telephone_number": "770-718-1122",
"fax_number": "770-533-4786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 JESSE JEWELL PKWY SE",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013834",
"telephone_number": "770-535-3611",
"fax_number": "770-535-7092"
}
],
"practiceLocations": [
{
"address_1": "4095 S Lee St",
"address_purpose": "LOCATION",
"city": "Buford",
"state": "GA",
"postal_code": "305183647",
"country_code": "US",
"telephone_number": "770-932-8519",
"fax_number": "770-533-4798",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4019 Executive Drive",
"address_purpose": "LOCATION",
"city": "Oakwood",
"state": "GA",
"postal_code": "305663433",
"country_code": "US",
"telephone_number": "770-533-6500",
"fax_number": "770-533-6543",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1270 Friendship Rd",
"address_purpose": "LOCATION",
"city": "Braselton",
"state": "GA",
"postal_code": "305175608",
"country_code": "US",
"telephone_number": "678-207-4200",
"fax_number": "770-533-4771",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "155 Professional Dr",
"address_purpose": "LOCATION",
"city": "Baldwin",
"state": "GA",
"postal_code": "305114000",
"country_code": "US",
"telephone_number": "706-776-2368",
"fax_number": "706-776-2589",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRINDLE",
"first_name": "CHRISTY",
"middle_name": "LEA",
"credential": "CPNP-PC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-27",
"last_updated": "2025-10-30",
"certification_date": "2025-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "APRN-NP136984",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "441164",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "787541872E",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "441165",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "787541872F",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "441157",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "441150",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "787541872A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "787541872C",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTY",
"last_name": "WALLIS",
"middle_name": "LEA",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.