Individual provider Active NPI

Grayson Stockwell, FNP-C

  • Family Nurse Practitioner
  • Dayton, TX
National Provider Identifier
1861369068
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1106879 Issued in TX
Practice address
101 S Prairie St
Dayton, TX 77535-2819
Phone
(936) 340-5517
NPI assigned
Oct 21, 2025
Last updated
Dec 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1106879 TX Primary

Addresses

Primary practice location

101 S Prairie St
Dayton, TX 77535-2819

Mailing address

469 County Road 2098
Liberty, TX 77575-6583
Phone (832) 785-0820

Other names 1

  • Grayson Gibbs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260413001551 TX Practitioner - Nurse Practitioner 8224503719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2708 Jefferson Dr
Suite a
Liberty, TX 77575-4303
Phone (936) 334-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1106879TXMDFamily Nurse Practitioner

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, 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": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1861369068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 COUNTY ROAD 2098",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775756583",
            "telephone_number": "832-785-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S PRAIRIE ST",
            "city": "DAYTON",
            "state": "TX",
            "postal_code": "775352819",
            "telephone_number": "936-340-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKWELL",
        "first_name": "GRAYSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1106879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRAYSON",
            "last_name": "GIBBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, TX

Sources for this page

Verify at the official NPI Registry.