Grace Medical Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GRACE MEDICAL INC

Practice address

355 S Teller St
Suite 200
Lakewood, CO 80226-7390

Phone

(866) 514-7223

Fax

(866) 823-2252

NPI assigned

Aug 7, 2014

Organization subpart

No

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

Authorized official

Name

Sandi Mattox

Title

Owner

Phone

(651) 430-8184

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1720497373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 2ND ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824059",
            "telephone_number": "651-430-8184",
            "fax_number": "866-823-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 S TELLER ST",
            "address_2": "SUITE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802267390",
            "telephone_number": "866-514-7223",
            "fax_number": "866-823-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "MATTOX",
        "authorized_official_first_name": "SANDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-430-8184"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12229873",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nour El Houda Goucem
• Hailey Gould, BCBA
• Sara Goyzueta, PA-C
• Grace E. Rudersdorf, DDS, PLLC
• Grace Leedy, LLC
• Grace Physical Therapy, LLC
• Anand Grace
• Leana Kaye Grace, DDS
• Laura Graham, FNP-C
• Stephen Patrick Graham, RN

• Durable Medical Equipment & Medical Supplies in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Durable Medical Equipment & Medical Supplies in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.