Grace Dent P.a.

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

4356-12 Issued in WI

Legal business name

GRACE DENT P.A.

Practice address

N4W22370 Bluemound Rd
Waukesha, WI 53186-1683

Phone

(262) 970-5610

NPI assigned

Feb 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Sage Campione, DC

Title

Owner

Phone

(813) 416-7714

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1598061640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N4W22370 BLUEMOUND RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861683",
            "telephone_number": "262-970-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N4W22370 BLUEMOUND RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861683",
            "telephone_number": "262-970-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE DENT P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "CAMPIONE",
        "authorized_official_first_name": "SAGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-416-7714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "WI",
            "license": "4356-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisol Gotay
• Stephen Goth, M.D.
• Alyssa Gottwald, RDN
• Allyssa Goulder, MA
• Jami Ann Graber, RN
• Aaron John Grace, PSY.D.
• Judith L Grady, LCSW
• Taylor Graf
• Melonie Graham
• Deborah D Gramdorf IX

• Nutrition Chiropractor in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Nutrition Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.