NPIMap

Organization Active NPI

Grace Path LLC

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Wesley, AR
National Provider Identifier
1679313225
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
Legal business name
GRACE PATH LLC
Practice address
12195 Elk RDG
Wesley, AR 72773-9109
Phone
(479) 225-3505
NPI assigned
May 30, 2024
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Ms. Jennifer Bowen, RN
Title
Owner
Phone
(918) 575-4849

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X Primary

Addresses

Primary practice location

12195 Elk RDG
Wesley, AR 72773-9109

Mailing address

12195 Elk RDG
Wesley, AR 72773-9109
Phone (479) 225-3505

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1679313225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12195 ELK RDG",
            "city": "WESLEY",
            "state": "AR",
            "postal_code": "727739109",
            "telephone_number": "479-225-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12195 ELK RDG",
            "city": "WESLEY",
            "state": "AR",
            "postal_code": "727739109",
            "telephone_number": "479-225-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE PATH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-575-4849",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.