Individual provider Active NPI

Lacie Grubbe, RN,BSN

  • Pediatric Registered Nurse
  • Austin, TX
National Provider Identifier
1982953261
Registry record updated Sep 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
786889 Issued in TX
Practice address
5009 Cana CV
Austin, TX 78749-4687
Phone
(918) 504-4376
NPI assigned
Sep 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 786889 TX Primary

Addresses

Primary practice location

5009 Cana CV
Austin, TX 78749-4687

Mailing address

5009 Cana CV
Austin, TX 78749-4687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
786889TXMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1346544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346544000000",
    "number": "1982953261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5009 CANA CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787494687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5009 CANA CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787494687",
            "telephone_number": "918-504-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBBE",
        "first_name": "LACIE",
        "credential": "RN,BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-02",
        "last_updated": "2012-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "786889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2012; 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.