Sean Davvid Grace

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

14430 NS 3500
Konawa, OK 74849-4901

Phone

(580) 925-2650

NPI assigned

Sep 30, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1982211223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 W 7TH ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203236",
            "telephone_number": "405-584-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14430 NS 3500",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748494901",
            "telephone_number": "580-925-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "SEAN",
        "middle_name": "DAVVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J083106885",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Konawa",
            "affiliation": "N",
            "address_1": "14430 Ns 3500",
            "city": "Konawa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "748494901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Keith Farmer
• Dawn J Fouch, COTA
• Charles Houston Furr
• Roberto Bonilla Gallegos
• Leslie Dawn Goodman
• Shakila Kashawn Green, CMII
• William Green
• Paul R Grimes, PHARMD
• Anja Lee Grissom, MED & LPC
• Dave Garrett Herriman

• Case Manager/Care Coordinator in Konawa, OK
• Providers in Konawa, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.