Individual provider Active NPI

Gracyn Ann Tabor

  • Physician Assistant
  • Iowa City, IA
National Provider Identifier
1841049079
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
137323 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-4901
Fax
(319) 353-6399
NPI assigned
May 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 137323 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-4901

Other practice location 1

540 E Jefferson St Ste 400
Iowa City, IA 52245-2479
Phone (319) 356-4901

Other practice location 2

500 E Market St
Iowa City, IA 52245-2633
Phone (319) 339-3551

Other practice location 3

105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20260626001386 IA Practitioner - Physician Assistant 9032682414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1841049079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-4901",
            "fax_number": "319-353-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-4901",
            "fax_number": "319-353-6399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 E Jefferson St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522452479",
            "country_code": "US",
            "telephone_number": "319-356-4901",
            "fax_number": "319-353-6399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 E Market St",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522452633",
            "country_code": "US",
            "telephone_number": "319-339-3551",
            "fax_number": "319-248-7945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E 9th St",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412209",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABOR",
        "first_name": "GRACYN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "137323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.