Individual provider Active NPI

Grace Yu-Haesung Bray, FNP-BC

  • Family Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1740636042
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173485 Issued in VA
Practice address
984B Laskin Rd
Virginia Beach, VA 23451-3905
Phone
(757) 395-6900
NPI assigned
May 5, 2016
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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 0024173485 VA Primary

Addresses

Primary practice location

984B Laskin Rd
Virginia Beach, VA 23451-3905

Mailing address

984B Laskin Rd
Virginia Beach, VA 23451-3905
Phone (757) 395-6900

Other practice location 1

9376 Atlee Station Rd
Mechanicsville, VA 23116-2602
Phone (804) 730-0990

Other identifiers 2

IdentifierTypeStateIssuer
1740636042MedicaidVA
0024173485OtherVAVIRGINIA STATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20160815000963 VA Practitioner - Nurse Practitioner 0042504029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

984 B Laskin Rd
Virginia Beach, VA 23451-3905
Phone (757) 395-6900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024173485VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little Clinic of VA LLC Family CurrentSince Jun 10, 2016 Accepting new patients
Sentara Medical Group CurrentSince Aug 23, 2021 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

7000 Tim Price Way
North Chesterfield, VA 23225
Phone (804) 772-8541

9000 Staples Mill Rd
Richmond, VA 23228
Phone (804) 977-9515

984B Laskin Rd
Virginia Beach, VA 23451
Phone (757) 395-6900

Organizations & group practices 2

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1740636042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984B LASKIN RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234513905",
            "telephone_number": "757-395-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984B LASKIN RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234513905",
            "telephone_number": "757-395-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9376 Atlee Station Rd",
            "address_purpose": "LOCATION",
            "city": "Mechanicsville",
            "state": "VA",
            "postal_code": "231162602",
            "country_code": "US",
            "telephone_number": "804-730-0990",
            "fax_number": "804-730-3375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAY",
        "first_name": "GRACE",
        "middle_name": "YU-HAESUNG",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740636042",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA STATE MEDICAL LICENSE",
            "identifier": "0024173485",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.