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GRACE HEALTHCARE GROUP PLLC
NPI 1245863901
Physician Assistant - Medical in White Pine, TN

Active since February 20, 2020CLIA 44D2200869 · Waiver
1721 MAIN ST, WHITE PINE, TN 37890(865) 761-0103(865) 761-0272 Get Directions Write a Review

NPPES record last updated: February 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grace Healthcare Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE HEALTHCARE GROUP PLLC (NPI 1245863901) is a healthcare organization registered as a medical in White Pine, Tennessee and active in the NPI registry since February 2020. The organization holds a CLIA Waiver certificate valid through November 16, 2026 and lists Ursula M Treadaway, Pac/owner, as its authorized official.

NPPES Registry Identity

NPI1245863901
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameGRACE HEALTHCARE GROUP PLLC
Location Address1721 MAIN STWhite Pine, TN 37890-3303
Mailing AddressPo Box 74White Pine, TN 37890-0074 · (865) 761-0103
Phone(865) 761-0103
Fax(865) 761-0272
Organization SubpartNo
Authorized OfficialUrsula M TreadawayPac/owner · (865) 761-0103
Enumeration DateFebruary 20, 2020
✔ NPI 1245863901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
1721 MAIN ST, White Pine, TN 37890
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2200869

Grace Healthcare Group PLLC · Bean Station, TN
Active · expires Nov 16, 2026
CLIA Number44D2200869
Laboratory TypePractitioner Other
Certificate Effective DateNovember 17, 2024
Certificate Expiration DateNovember 16, 2026
Laboratory DirectorUrsula M. Treadaway
Laboratory Phone(865) 761-0103
Laboratory LocationGrace Healthcare Group PLLC1038 Lakeshore Drive, Bean Station, TN 37708
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES B SCHINDLER MD
Family Medicine
1721 MAIN ST
WHITE PINE, TN 37890
Jefferson County (865) 674-6400
SCHINDLER MEDICAL LLC
Family Medicine
1721 MAIN ST
WHITE PINE, TN 37890
Jefferson County (865) 674-6400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grace Healthcare Group PLLC's NPI number?

The NPI number for Grace Healthcare Group PLLC is 1245863901. It was assigned to this organization in the NPPES registry on February 20, 2020.

Where is Grace Healthcare Group PLLC located?

Grace Healthcare Group PLLC is located at 1721 Main St, White Pine, TN 37890. The listed phone number is (865) 761-0103.

What is Grace Healthcare Group PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Does Grace Healthcare Group PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2200869) is associated with this NPI, valid through November 16, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grace Healthcare Group PLLC was last updated on February 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.