Active NPI
Grace A Shirley, ARNP
- Nurse Practitioner
- Minnetonka, MN
National Provider Identifier
1770722670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP 1666002
- Practice address
- 9900 Bren Rd E
Minnetonka, MN 55343-9664 - Phone
- (407) 963-2919
- NPI assigned
- Feb 17, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP 1666002 | FL | Primary |
Addresses
Primary practice location
9900 Bren Rd E
Minnetonka, MN 55343-9664
Mailing address
PO Box 1459
Minneapolis, MN 55440-1459
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
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 1666002 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Medical Group Inc | Nurse Practitioner | Past | Accepting new patients |
| Cardiovascular Surgeons, P.a. | Past | Accepting new patients |
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.
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- NPI 1225034234
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1770722670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1459",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554401459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664",
"telephone_number": "407-963-2919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRLEY",
"first_name": "GRACE",
"middle_name": "A",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-17",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP 1666002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.