Individual provider Active NPI

Stephen G Grace, MD

  • Plastic Surgery Physician
  • Reno, NV
National Provider Identifier
1609841758
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
3503 Issued in NV
Practice address
9480 Double Diamond Pkwy
Suite 105
Reno, NV 89521-5845
Phone
(775) 322-0515
Fax
(775) 322-0854
NPI assigned
Feb 22, 2006
Last updated
Jul 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 3503 NV Primary

Addresses

Primary practice location

9480 Double Diamond Pkwy
Suite 105
Reno, NV 89521-5845

Mailing address

9480 Double Diamond Pkwy
Suite 105
Reno, NV 89521-5845
Phone (775) 322-0515

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3503NVMDGeneral Practice Dentistry

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1609841758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9480 DOUBLE DIAMOND PKWY",
            "address_2": "SUITE 105",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215845",
            "telephone_number": "775-322-0515",
            "fax_number": "775-322-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 DOUBLE DIAMOND PKWY",
            "address_2": "SUITE 105",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215845",
            "telephone_number": "775-322-0515",
            "fax_number": "775-322-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "STEPHEN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NV",
            "license": "3503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.