Susan K Grace, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71000443 Issued in IN

Practice address

400 Teegarden St
Suite B
La Porte, IN 46350-3175

Phone

(219) 326-0043

Fax

(219) 326-8909

NPI assigned

Feb 14, 2007

Last updated

Dec 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1891838629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TEEGARDEN ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503175",
            "telephone_number": "219-326-0043",
            "fax_number": "219-326-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TEEGARDEN ST",
            "address_2": "SUITE B",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503175",
            "telephone_number": "219-326-0043",
            "fax_number": "219-326-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200812400",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Gnezda, DDS
• Dale A. Goodman, MD
• Sarah Ann Gore, DNP, APRN, FNP-BC
• David J Gorecki, MD
• Robert Mark Grace, DDS
• James Lewis Grainger, M.D.
• Grandfield Foot and Ankle P.C.
• Christopher S Grandfield, DPM
• Grant Chiropractic Clinic, Inc
• Mark Charles Grant

• Family Nurse Practitioner in La Porte, IN
• Providers in La Porte, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.