EAGLE MOUNTAIN HEALTHCARE LLC
NPI 1508563578
Nurse Practitioner - Primary Care in Azle, TX
About Eagle Mountain Healthcare Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAGLE MOUNTAIN HEALTHCARE LLC (NPI 1508563578) is a healthcare organization registered as a primary care in Azle, Texas and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through October 4, 2027 and lists Heather Grayson, Nurse Practitioner/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Eagle Mountain Healthcare Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Eagle Mountain Healthcare LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 45D2291112
Eagle Mountain Healthcare · Azle, TXFrequently 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 Eagle Mountain Healthcare LLC's NPI number?
The NPI number for Eagle Mountain Healthcare LLC is 1508563578. It was assigned to this organization in the NPPES registry on February 10, 2023.
Where is Eagle Mountain Healthcare LLC located?
Eagle Mountain Healthcare LLC is located at 807 Southeast Pkwy, Azle, TX 76020. The listed phone number is (817) 661-8197.
What is Eagle Mountain Healthcare LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Eagle Mountain Healthcare LLC enrolled in Medicare?
Yes. Eagle Mountain Healthcare LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Eagle Mountain Healthcare LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Eagle Mountain Healthcare LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Eagle Mountain Healthcare LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2291112) is associated with this NPI, valid through October 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Eagle Mountain Healthcare LLC accept?
Health plans from Blue Cross and Blue Shield of Texas list Eagle Mountain Healthcare LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Eagle Mountain Healthcare LLC was last updated on March 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Eagle Mountain Healthcare Llc · NPI 1508563578
Primary Care organization in Azle, Texas. Organization record, active in the CMS NPPES registry since February 10, 2023.
## Identity
- **NPI:** 1508563578 (Entity type: Organization)
- **Enumerated:** February 10, 2023
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Heather Grayson, NURSE PRACTITIONER/OWNER
## Practice location
- **Address:** 807 SOUTHEAST PKWY, Azle, TX 76020-3658
- **Phone:** (817) 661-8197
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 3, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1508563578) · Data from the CMS NPPES public registry.