Grace Services, LLC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

11054 Issued in TN

Legal business name

GRACE SERVICES, LLC

Doing business as

Grace Health Services

Practice address

2 Worth Cir
Suite 2
Johnson City, TN 37601-4306

Phone

(423) 283-4958

Fax

(423) 283-7135

NPI assigned

Apr 10, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Gordon E Coburn, APRN-BC

Title

Owner

Phone

(423) 283-4958

Specialties & licenses 1

Addresses

Other names 1

• Grace Health Services Doing business as

Locations

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1013336627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WORTH CIR",
            "address_2": "SUITE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014306",
            "telephone_number": "423-283-4958",
            "fax_number": "423-283-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WORTH CIR",
            "address_2": "SUITE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014306",
            "telephone_number": "423-283-4958",
            "fax_number": "423-283-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A",
        "authorized_official_last_name": "COBURN",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-283-4958",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN-BC"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "11054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Dane Gotfried, MD
• Edie B Gouge, PHARMD
• Clarence E Goulding III, MD
• Sagar Goyal, MD
• Grace Internal Medicine, LLC
• Matthew Grace, AGNP-C
• Anthony Grady
• Vickie L Gragg, PTA
• Graham Physical Therapy, LLC
• David H Graham, PT

• Psychiatric/Mental Health Registered Nurse in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychiatric/Mental Health Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.