Courtney R Grady

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3751 Pennridge Dr Ste 119
Bridgeton, MO 63044-1244

Phone

(314) 443-7776

Fax

(949) 561-4148

NPI assigned

Jan 23, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1962773986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 BROWNS LN",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017213",
            "telephone_number": "870-972-4939",
            "fax_number": "870-972-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 PENNRIDGE DR STE 119",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630441244",
            "telephone_number": "314-443-7776",
            "fax_number": "949-561-4148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2707 Browns Ln",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724017213",
            "country_code": "US",
            "telephone_number": "870-972-4939",
            "fax_number": "870-972-4911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRADY",
        "first_name": "COURTNEY",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Jo Gorman, M.D.
• Bryan John Goss, ACNP
• Thomas Michael Gotsis, DDS
• Kaitlyn Taylor Kristina Gotthardt
• Taryn Lorraine Gough
• Catherine M Graham, MD
• Robert Graninger, PT, DPT, ATC
• Jacob Graves, CCC-SLP
• Brian J. Gray, D.C.
• Great Providers LLC

• Counselor in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.