TABATHA GRACE NPI 1104402338

NPI Information

  • NPI: 1104402338
  • Provider Name: TABATHA GRACE
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1500 S WHITE MOUNTAIN RD BLDG 3
    SHOW LOW, AZ
    ZIP 85901
  • Phone: (928) 532-5838

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NPI Details

Tabatha Grace is a family nurse practitioner in Show Low, AZ with 6 years of experience. Tabatha Grace NPI is 1104402338. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1500 S WHITE MOUNTAIN RD BLDG 3
SHOW LOW, AZ
ZIP 85901-111
Phone: (928) 532-5838

The NPI 1104402338 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes (HCPCS:97110)
  • Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg (HCPCS:J7320)
  • Therapy procedure using functional activities (HCPCS:97530)
  • Application of mechanical traction (HCPCS:97012)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Injection of trigger points, 1-2 muscles (HCPCS:20552)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Injection of trigger points, 3 or more muscles (HCPCS:20553)
  • X-ray of lower and sacral spine, 2-3 views (HCPCS:72100)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • X-ray of upper spine, 2-3 views (HCPCS:72040)
  • X-ray of middle spine, 2 views (HCPCS:72070)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care (HCPCS:G0283)
  • X-ray of knee, 1-2 views (HCPCS:73560)

The enumeration date for this NPI number is 3/18/2021 and was last updated on 3/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily254322ARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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