Individual provider Active NPI

Tabitha Grady, WHNP-BC

  • Women's Health Nurse Practitioner
  • Holland, MI
National Provider Identifier
1952117152
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
4704300959 Issued in MI
Practice address
664 Michigan Ave
Holland, MI 49423-4944
Phone
(616) 392-5973
NPI assigned
Dec 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704300959 MI Primary

Addresses

Primary practice location

664 Michigan Ave
Holland, MI 49423-4944

Mailing address

3583 Arbor Chase CT NE
Grand Rapids, MI 49525-9454
Phone (928) 600-7779

Other practice location 1

655 Kenmoor Ave SE Ste 201
Grand Rapids, MI 49546-8604
Phone (616) 920-0825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20241217000212 MI Practitioner - Nurse Practitioner 1355878257 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breast Health and Wellness Center PCGroup PAC ID 6406175041, 3 clinicians
OBGYN Associates of Holland, PCGroup PAC ID 7214941244, 11 clinicians

Practice addresses (Care Compare)

655 Kenmoor Ave SE
Suite 201
Grand Rapids, MI 49546-8604
Phone (616) 920-0825

664 Michigan Ave
Holland, MI 49423-4944
Phone (616) 392-5973

Hospital & facility affiliations

  • Holland Hospital Hospital, Holland, MI, CCN 230072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
OB/GYN Associates of Holland, PC CurrentSince Dec 1, 2024 Accepting new patients
Breast Health & Wellness Center PC CurrentSince May 11, 2026 Accepting new patients

Locations

655 Kenmoor Ave SE
Ste 201
Grand Rapids, MI 49546
Phone (616) 920-0825

664 Michigan Ave
Holland, MI 49423
Phone (616) 392-5973

Interoperability endpoints

  • Direct secure messaging: tabithagrady@obgynahpc.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1952117152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3583 ARBOR CHASE CT NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259454",
            "telephone_number": "928-600-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234944",
            "telephone_number": "616-392-5973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Kenmoor Ave SE Ste 201",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495468604",
            "country_code": "US",
            "telephone_number": "616-920-0825",
            "fax_number": "616-920-0830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRADY",
        "first_name": "TABITHA",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704300959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.