Healthcare Provider Details

I. General information

NPI: 1295660892
Provider Name (Legal Business Name): GRACIOUS TRANSIT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9165 OTIS AVE STE 157
INDIANAPOLIS IN
46216-2312
US

IV. Provider business mailing address

9165 OTIS AVE STE 157
INDIANAPOLIS IN
46216-2312
US

V. Phone/Fax

Practice location:
  • Phone: 463-302-0217
  • Fax: 463-302-0217
Mailing address:
  • Phone: 463-302-0217
  • Fax: 463-302-0217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JAMES NICKENS SR.
Title or Position: OWNER
Credential: CEO
Phone: 463-302-0217