Jhonny D Grady

Primary specialty

Drama TherapistTaxonomy code 101200000X

License

G6304246825900 Issued in WI

Practice address

5839 N Teutonia Ave
Milwaukee, WI 53209-4161

Phone

(917) 719-4698

NPI assigned

Aug 26, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1629745658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5839 N TEUTONIA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532094161",
            "telephone_number": "917-719-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5839 N TEUTONIA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532094161",
            "telephone_number": "917-719-4698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Knight St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770222742",
            "country_code": "US",
            "telephone_number": "917-719-4698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRADY",
        "first_name": "JHONNY",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101200000X",
            "taxonomy_group": "",
            "desc": "Drama Therapist",
            "state": "WI",
            "license": "G6304246825900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G6304246825900",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "9177194698",
            "affiliation": "N",
            "address_1": "5839 N Teutonia Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532094161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maciej Gracz
• Samantha A Gracz, CTRS
• Jenna Gradinjan, PHARMD
• Allison L Grady, NP
• Damira Grady
• Michael Edward Grady, D.D.S.
• Michelle Nohealani Grady, MD
• Sheila Rene Grady, BA
• Richard H Graebner, CP
• Kristine R. Graettinger, M.D.

• Drama Therapist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Drama Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.