GRACE THERAPY LLC — NPI 1174472005 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in NETTLETON, MS)

CMS-1500 Box 24J / 33a • NPI

1174472005

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QM0801X (CMS B4[14])

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

172 YOUNG AVE, NETTLETON, MS, 38858-6010

✓ 9-Digit EDI 837 ZIP+4 (38858-6010)

Practice Phone & Referral Fax

(662) 591-1030

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1174472005 (GRACE THERAPY LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1174472005` (NPI-2 Organization / Facility)
Provider / Legal Name	GRACE THERAPY LLC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QM0801X` (Clinic/Center, Mental Health (Including Community Mental Health Center))
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	172 YOUNG AVE, NETTLETON, MS, 38858-6010
Practice Telephone / Fax	Tel: (662) 591-1030
Administrative Mailing Address	432 ROAD 1203, NETTLETON, MS, 38858-8283
Enumeration & Last Sync	Enumerated: 2026-01-23 \| CMS Record Updated: 2026-01-23
Authorized Official	DEBORRA RIKARD (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

172 YOUNG AVE, NETTLETON, MS, 38858-6010

🗺️ Open in Google Maps 🏥 More Providers in NETTLETON

🔒 Are you GRACE THERAPY LLC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (261QM0801X)

What Does Taxonomy Code 261QM0801X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QM0801X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code B4[14] (Community Mental Health Center)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (GRACE THERAPY LLC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QM0801X` — Clinic/Center, Mental Health (Including Community Mental Health Center) Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

GRACE THERAPY LLC (NPI #1174472005)