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AMAZING GRACE PRIMARY CARE, LLC
NPI 1821702663
Nurse Practitioner - Family in Chiefland, FL

Active since January 06, 2023CLIA 10D2279137 · Waiver
110 E PARK AVE, CHIEFLAND, FL 32626(352) 949-0478(352) 752-3305 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 17, 2025, Jan 6, 2023 (2 updates tracked since 2023).

About Amazing Grace Primary Care, Llc NPPES

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

AMAZING GRACE PRIMARY CARE, LLC (NPI 1821702663) is a healthcare organization registered as a family in Chiefland, Florida and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through March 28, 2027 and lists Sally Martinez, Ceo, as its authorized official.

NPPES Registry Identity

NPI1821702663
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameAMAZING GRACE PRIMARY CARE, LLC
Location Address110 E PARK AVEChiefland, FL 32626-0901
Mailing Address110 E Park AveChiefland, FL 32626-0901 · (352) 949-0478 · Fax (352) 754-3305
Phone(352) 949-0478
Fax(352) 752-3305
Organization SubpartNo
Authorized OfficialSally MartinezCeo · (352) 339-8981
Enumeration DateJanuary 6, 2023
Last NPPES UpdateDecember 17, 20252 updates tracked since enumeration
NPPES CertifiedDecember 17, 2025
✔ NPI 1821702663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedNurse Practitioner · Women's HealthTaxonomy 363LW0102X
110 E PARK AVE, Chiefland, FL 32626
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.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)

Amazing Grace Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Amazing Grace Primary Care, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Sally Martinez, FNP-BC, DNP
Nurse Practitioner
NPI 1720235864
110 E PARK AVE
Chiefland, FL 32626
(352) 339-8981
✔ PECOS✔ Accepts MedicareSame address

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 10D2279137

Amazing Grace Primary Care LLC · Chiefland, FL
Active · expires Mar 28, 2027
CLIA Number10D2279137
Laboratory TypePhysician Office
Certificate Effective DateMarch 29, 2025
Certificate Expiration DateMarch 28, 2027
Laboratory DirectorSally Martinez
Laboratory Phone(352) 949-0478
Laboratory LocationAmazing Grace Primary Care LLC410 N Main Street Suite 11, Chiefland, FL 32626
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Amazing Grace Primary Care, LLC's NPI number?

The NPI number for Amazing Grace Primary Care, LLC is 1821702663. It was assigned to this organization in the NPPES registry on January 6, 2023.

Where is Amazing Grace Primary Care, LLC located?

Amazing Grace Primary Care, LLC is located at 110 E Park Ave, Chiefland, FL 32626. The listed phone number is (352) 949-0478.

What is Amazing Grace Primary Care, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Amazing Grace Primary Care, LLC enrolled in Medicare?

Yes. Amazing Grace Primary Care, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Amazing Grace Primary Care, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Amazing Grace Primary Care, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Amazing Grace Primary Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2279137) is associated with this NPI, valid through March 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Amazing Grace Primary Care, LLC accept?

Health plans from Ambetter Health and Ambetter of Alabama list Amazing Grace Primary Care, 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 Amazing Grace Primary Care, LLC was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.