NPIMap

Organization Active NPI

Grace Family Services Inc

  • Psychiatry Physician
  • North Myrtle Beach, SC
National Provider Identifier
1003549759
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GRACE FAMILY SERVICES INC
Practice address
2406 Madison Dr
North Myrtle Beach, SC 29582-4334
Phone
(843) 663-0748
Fax
(843) 663-0749
NPI assigned
Jul 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gene Smith
Title
Ceo
Phone
(910) 385-6424

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Community/Behavioral Health Agency 251S00000X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

2406 Madison Dr
North Myrtle Beach, SC 29582-4334

Mailing address

2406 Madison Dr
North Myrtle Beach, SC 29582-4334
Phone (843) 663-0748

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL GSmith1954@gsmithgracefamilyservices.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241001000677 SC Part B Supplier - Clinic/Group Practice 5294274841 Receives reassigned benefits from 4 practitioners
Practice locations: North Myrtle Beach, SC

National Provider Directory

National Provider Directory

Locations

13972 US Highway 701 N
Garland, NC 28441
Phone (910) 385-6424

1409 Pinckney St
Ste A
Whiteville, NC 28472

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1003549759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 MADISON DR",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295824334",
            "telephone_number": "843-663-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 MADISON DR",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295824334",
            "telephone_number": "843-663-0748",
            "fax_number": "843-663-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FAMILY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2024-07-22",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-385-6424"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "GSmith1954@gsmithgracefamilyservices.com",
            "affiliation": "N",
            "address_1": "1409 Pinckney St Ste A",
            "city": "Whiteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284722220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.