Grace Gombe Munthali, APRN, NP,RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2018012589 Issued in MO

Practice address

600 E 5TH St
Fulton, MO 65251-1753

Phone

(573) 592-2623

NPI assigned

Jan 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Compass Health IncGroup PAC ID 1951206754, 317 clinicians

State of MissouriGroup PAC ID 1456254226, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Compass Health, Inc

  • Community/Behavioral Health Agency
  • Clinton, MO
  • NPI 1285619494
  Medicare reassignment Care Compare group NPD
• State of Missouri

  • Psychiatry Physician
  • Fulton, MO
  • NPI 1164477873
  Medicare reassignment Care Compare group NPD
• Compass Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Rolla, MO
  • NPI 1558258632
  NPD
• State of Missouri

  • Psychiatry Physician
  • Kansas City, MO
  • NPI 1386198448
  NPD

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1770949406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 5TH ST",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511753",
            "telephone_number": "573-592-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 5TH ST",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511753",
            "telephone_number": "573-592-2623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "227 Metro Dr",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651091134",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNTHALI",
        "first_name": "GRACE",
        "middle_name": "GOMBE",
        "credential": "APRN, NP,RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2010002416",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015025656",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2018012589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Miller, R.PH.
• Missouri CVS Pharmacy, L.L.C.
• Missouri Em-I Medical Services PC
• Laura Elizabeth Morris, M.D.
• Mendy Lynn Mullins, LCSW
• N & R of Fulton, Inc.
• Patrick D Neff, DDS
• William Newbill, PH.D.
• Newton Emergency Group, LLC
• Nghia Nguyen, DC

• Psychiatric/Mental Health Nurse Practitioner in Fulton, MO
• Providers in Fulton, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.