Individual provider Active NPI

Grace Muange-Kambumba, RN

  • Nurse Practitioner
  • Kyle, TX
National Provider Identifier
1982019626
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1141112 Issued in TX
Practice address
1300 Dacy LN Ste 140
Kyle, TX 78640-4195
Phone
(512) 871-6300
NPI assigned
Jun 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1141112 TX Primary

Addresses

Primary practice location

1300 Dacy LN Ste 140
Kyle, TX 78640-4195

Mailing address

382 Lake Washington Dr
Kyle, TX 78640-5760
Phone (503) 875-1956

Other names 1

  • Grace Tshimanga 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
I20250522002238 TX Practitioner - Nurse Practitioner 9931558707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Republic Spine and Pain, PAGroup PAC ID 9335333863, 14 clinicians

Practice addresses (Care Compare)

13617 Caldwell Dr
Suite 100
Austin, TX 78750-2324
Phone (512) 219-8787

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Republic Spine and Pain, P.a. CurrentSince Apr 1, 2025 Accepting new patients

Locations

13617 Caldwell Dr
Ste 100
Austin, TX 78750
Phone (512) 219-8787

13617 Caldwell Dr
Austin, TX 78750
Phone (907) 980-6957

1623 Rivery Blvd
Georgetown, TX 78628
Phone (512) 219-8787

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18125/brand/1/csg/1/fhir/r4
  • Direct secure messaging: grace.muange-kambumba.1@18125.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1982019626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 LAKE WASHINGTON DR",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786405760",
            "telephone_number": "503-875-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 DACY LN STE 140",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786404195",
            "telephone_number": "512-871-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUANGE-KAMBUMBA",
        "first_name": "GRACE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1141112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "TSHIMANGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kyle, TX

Sources for this page

Verify at the official NPI Registry.