Individual provider Active NPI

Grace Klein, RN, PH.D

  • Adult Psychiatric/Mental Health Registered Nurse
  • Rochester, NY
National Provider Identifier
1760856157
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
NY373483 Issued in NY
Practice address
15 Arnold Park
Rochester, NY 14607-2001
Phone
(585) 473-2733
Fax
(585) 473-5472
NPI assigned
Nov 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 373483-1 NY
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X NY373483 NY Primary

Addresses

Primary practice location

15 Arnold Park
Rochester, NY 14607-2001

Mailing address

15 Arnold Park
Rochester, NY 14607-2001
Phone (585) 473-2733

Other names 1

  • Dr. Grace Chickadonz Former name

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
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
373483-1NYMDRegistered Nurse
NY373483NYMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1760856157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ARNOLD PARK",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072001",
            "telephone_number": "585-473-2733",
            "fax_number": "585-473-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ARNOLD PARK",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072001",
            "telephone_number": "585-473-2733",
            "fax_number": "585-473-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "RN, PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "373483-1",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "NY373483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "CHICKADONZ",
            "prefix": "DR.",
            "credential": "RN, PH.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.