Amazing Grace Primary Care, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

AMAZING GRACE PRIMARY CARE, LLC

Practice address

110 E Park Ave
Chiefland, FL 32626-0901

Phone

(352) 949-0478

Fax

(352) 752-3305

NPI assigned

Jan 6, 2023

Last updated

Dec 17, 2025By 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

Sally Martinez, FNP-BC, DNPNPI 1720235864

Title

Ceo

Phone

(352) 339-8981

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 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.

• Sally Teadt Martinez, FNP-BC, DNP

  • Family Nurse Practitioner
  • Chiefland, FL
  • NPI 1720235864
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1821702663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E PARK AVE",
            "city": "CHIEFLAND",
            "state": "FL",
            "postal_code": "326260901",
            "telephone_number": "352-949-0478",
            "fax_number": "352-754-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E PARK AVE",
            "city": "CHIEFLAND",
            "state": "FL",
            "postal_code": "326260901",
            "telephone_number": "352-949-0478",
            "fax_number": "352-752-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-339-8981",
        "authorized_official_credential": "FNP-BC, DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Woman's Place, Inc.
• Corey James Aderholt, PHARMD
• Avery Partners, Inc (Avery Rehab Chiefland)
• Avery Partners, Inc (Avery Rehabilitation)
• Matthew Barber, APRN
• Meagan Jane Barnette, PTA
• Mohammed Muneer Basha, MD.

• Family Nurse Practitioner in Chiefland, FL
• Providers in Chiefland, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.