Individual provider Active NPI

Grace Stonecypher Henson

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1639728744
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903550 Issued in MS
Practice address
670 Crossover Rd
Tupelo, MS 38801-4944
Phone
(662) 844-8414
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 903550 MS Primary

Addresses

Primary practice location

670 Crossover Rd
Tupelo, MS 38801-4944

Mailing address

670 Crossover Rd
Tupelo, MS 38801-4944

Other practice location 1

210 Hwy 30 W
New Albany, MS 38652-3112
Phone (662) 539-7014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191220000256 MS Practitioner - Nurse Practitioner 2668806928 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
903550MSMDFamily Nurse Practitioner
905228MSMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
Southeastern Emergency Physicians LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

Interoperability endpoints

  • Direct secure messaging: gracehenson@nmhs.medalliesdirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1639728744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 CROSSOVER RD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 CROSSOVER RD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014944",
            "telephone_number": "662-844-8414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Hwy 30 W",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "MS",
            "postal_code": "386523112",
            "country_code": "US",
            "telephone_number": "662-539-7014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSON",
        "first_name": "GRACE",
        "middle_name": "STONECYPHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.