Roshanda Grayson-Thomas, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71010601A Issued in IN

Practice address

6050 Sterling Creek Rd
Portage, IN 46368-7752

Phone

(219) 219-7638

NPI assigned

Feb 8, 2017

Last updated

Dec 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mendocino Community Health Clinic IncGroup PAC ID 6305755455, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/AECBBA
• Direct secure messaging: roshanda.graysonthomas.p1@direct.northshorehealth.nextgenshare.com

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.

• Mendocino Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1497961106
  Medicare reassignment Care Compare group NPD
• Spero Health of Indiana, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Indianapolis, IN
  • NPI 1962900183
  Medicare reassignment NPD
• Affect Therapeutics Inc

  dba Affect Therapeutics

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Charlottesville, VA
  • NPI 1104402064

  CA, Registered Nurse

  Medicare reassignment NPD
• Long Valley Health Center

  • Clinic/Center
  • Laytonville, CA
  • NPI 1366467375
  Medicare reassignment NPD
• Mendocino Coast Clinics Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Bragg, CA
  • NPI 1609595404
  Medicare reassignment NPD
• Greater Lakes Behavioral Health Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portage, IN
  • NPI 1932816923
  NPD Authorized official
• Mendocino Coast Clinics Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Bragg, CA
  • NPI 1083783757
  NPD
• Mendocino Coast Clinics, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Bragg, CA
  • NPI 1285128595
  NPD
• Mendocino Community Health Clinic, Inc.

  dba Dora Street Health Center

  • Federally Qualified Health Center (FQHC)
  • Ukiah, CA
  • NPI 1356714646
  NPD
• Affect Provider Group P.S.C.

  dba Affect

  • Mental Health Counselor
  • Indianapolis, IN
  • NPI 1508748203

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1619415874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 STERLING CREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463687752",
            "telephone_number": "219-763-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 STERLING CREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463687752",
            "telephone_number": "219-219-7638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 W 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Gary",
            "state": "IN",
            "postal_code": "464021711",
            "country_code": "US",
            "telephone_number": "219-885-4264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAYSON-THOMAS",
        "first_name": "ROSHANDA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71010601A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28201839A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Gonzales, PHARM D
• Gabrielle Gonzalez, MS, BCBA
• Meghan Goranson, PTA
• Cimone Lynae Gordon
• Lisa Gorski
• Great Lakes Senior Care, LLC (Home Helpers)
• Greater Lakes Behavioral Health Services LLC
• L. Allen Grecula
• Darcie A Gresham, OTR
• Stephanie L. Grider, DMD

• Psychiatric/Mental Health Nurse Practitioner in Portage, IN
• Providers in Portage, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.