All Grace Medical Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ALL GRACE MEDICAL CLINIC LLC

Practice address

3951 Ferrara Dr
Silver Spring, MD 20906-4709

Phone

(240) 481-0252

NPI assigned

Feb 2, 2021

Last updated

Aug 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justine Embele, CRNP

Title

Nurse Practitioner

Phone

(240) 481-0252

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1053902916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3951 FERRARA DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064709",
            "telephone_number": "240-481-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3951 FERRARA DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064709",
            "telephone_number": "240-481-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL GRACE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "EMBELE",
        "authorized_official_first_name": "JUSTINE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "240-481-0252",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.