Individual provider Active NPI

Gabrielle Grandell, FMCHC

  • Nutrition Education Nutritionist
  • Dallas, TX
National Provider Identifier
1720520315
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
Practice address
17000 Preston Rd Ste 400
Dallas, TX 75248-1201
Phone
(972) 930-0260
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X Primary

Addresses

Primary practice location

17000 Preston Rd Ste 400
Dallas, TX 75248-1201

Mailing address

120 W Cityline Dr Apt 3048
Richardson, TX 75082-3366
Phone (817) 715-0512

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

Practice roles

OrganizationSpecialtyStatusNew patients
Living Well Dallas, Inc. CurrentSince Aug 23, 2020 Accepting new patients

Locations

17000 Preston Rd
Ste 400
Dallas, TX 75248
Phone (972) 930-0260

Organizations & group practices 1

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": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1720520315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W CITYLINE DR APT 3048",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823366",
            "telephone_number": "817-715-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 PRESTON RD STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481201",
            "telephone_number": "972-930-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDELL",
        "first_name": "GABRIELLE",
        "credential": "FMCHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.