Beautifully Graced LLC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Legal business name

BEAUTIFULLY GRACED LLC

Practice address

2155 Palm Bay Rd NE Ste 7
Palm Bay, FL 32905-2907

Phone

(321) 220-0862

NPI assigned

Aug 30, 2022

Last updated

Jan 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie Denise JernighanNPI 1962076331

Title

Founder

Phone

(321) 220-0862

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie D Jernighan

  • Developmental Therapist
  • Palm Bay, FL
  • NPI 1962076331

  Health & Wellness Coach

  NPD Authorized official

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1811617863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 PALM BAY RD NE STE 7",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052907",
            "telephone_number": "321-220-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 PALM BAY RD NE STE 7",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052907",
            "telephone_number": "321-220-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFULLY GRACED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "JERNIGHAN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "321-220-0862",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COSMETOLOGY LICENSE",
            "identifier": "CL1284556",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@beautifullygracedllc.com",
            "affiliation": "N",
            "address_1": "2155 Palm Bay Rd NE Ste 7",
            "city": "Palm Bay",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329052907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Health & Wellness Coach in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Health & Wellness Coach in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.