Individual provider Active NPI

Grace Charles

  • Registered Nurse
  • Jamaica, NY
National Provider Identifier
1699638627
Registry record updated Sep 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
939349 Issued in NY
Practice address
17513 110TH Ave
Jamaica, NY 11433-3453
Phone
(954) 667-4183
NPI assigned
Dec 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 939349 NY Primary

Addresses

Primary practice location

17513 110TH Ave
Jamaica, NY 11433-3453

Mailing address

17513 110TH Ave
Jamaica, NY 11433-3453

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
939349NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1764892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788566400000",
    "number": "1699638627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17513 110TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114333453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17513 110TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114333453",
            "telephone_number": "954-667-4183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-05",
        "last_updated": "2026-09-05",
        "certification_date": "2026-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "939349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2026; 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.