GRACE PURCELL RAEDEKE MD
NPI 1356286942
Student in an Organized Health Care Education/Training Program in Lubbock, TX

Q: What is Grace Raedeke's NPI number?

The NPI number for Grace Raedeke is 1356286942. It was assigned to this individual provider in the NPPES registry on April 21, 2026.

Q: What is Grace Raedeke's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Grace Raedeke was last updated on April 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.

Active since April 21, 2026PECOS Enrolled

3601 4TH ST STOP 8340, LUBBOCK, TX 79430(806) 743-1946 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Grace Purcell Raedeke Md NPPES

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

GRACE PURCELL RAEDEKE MD (NPI 1356286942) is an individual student in an organized health care education/training program in Lubbock, Texas and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356286942

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameGRACE PURCELL RAEDEKECredential: MD

Location Address3601 4TH ST STOP 8340Lubbock, TX 79430-8340

Mailing Address4017 123rd StLubbock, TX 79423-7511

Phone(806) 743-1946

Sole ProprietorNo

Enumeration DateApril 21, 2026

NPPES CertifiedApril 21, 2026

✔ NPI 1356286942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3601 4TH ST STOP 8340, Lubbock, TX 79430

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grace Purcell Raedeke Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

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

AVERY CLAIRE WILLIAMS MD

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