Individual provider Active NPI

Shianne Grace

  • Psychiatric/Mental Health Nurse Practitioner
  • South Yarmouth, MA
National Provider Identifier
1801420658
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11012808 Issued in FL
Practice address
168 Wood Rd
South Yarmouth, MA 02664-4228
Phone
(508) 292-6730
NPI assigned
Mar 2, 2020
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 2359760 MA
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 11012808 FL Primary

Addresses

Primary practice location

168 Wood Rd
South Yarmouth, MA 02664-4228

Mailing address

168 Wood Rd
South Yarmouth, MA 02664-4228

Other practice location 1

1725 W Dr Mlk Blvd Ste 109
Tampa, FL 33607-6507
Phone (813) 393-1796

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

LicenseStateTypeSpecialty
11012808FLMDPsychiatric/Mental Health Nurse Practitioner
2359760MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saving Grace Behavioral Health Multi-Specialty CurrentSince Dec 10, 2023 Accepting new patients
Saving Grace Behavioral Health Multi-Specialty CurrentSince Nov 1, 2021 Accepting new patients

Locations

1725 W Mlk Blvd
Ste 109
Tampa, FL 33607
Phone (508) 292-6730

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.

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1801420658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 WOOD RD",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026644228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 WOOD RD",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026644228",
            "telephone_number": "508-292-6730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 W Dr Mlk Blvd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076507",
            "country_code": "US",
            "telephone_number": "813-393-1796",
            "fax_number": "813-491-7826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACE",
        "first_name": "SHIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2359760",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11012808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Yarmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.