Grace Glass

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-11587 Issued in NC

Practice address

4350 US 421 S
Lillington, NC 27546-6760

Phone

(910) 893-1210

NPI assigned

Jan 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Family Care Fuquay PLLCGroup PAC ID 6103258306, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• American Family Care Fuquay PLLC

  • Urgent Care Clinic/Center
  • Fuquay Varina, NC
  • NPI 1770135808
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1610755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1073102760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 MARQUEE LN",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263208",
            "telephone_number": "678-826-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 US 421 S",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275466760",
            "telephone_number": "910-893-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-16",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zulaikha Ghani, DO
• Stephen Todd Gill, PHD DR
• Avraham Ginsburg, DO
• David Kalman Gittelman, D.O.
• Aaron Bishop Glass, O.D.
• Victoria Elizabeth Glockzin
• Robert Goldbach, MD
• Saul Gonzalez, DMD
• Bianca L Goo, PA-C
• Johanna Rennhack Goodwin, PA

• Physician Assistant in Lillington, NC
• Providers in Lillington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.