Active NPI
Michael Jerome Grady, D.O.
- Specialist
- Conyers, GA
National Provider Identifier
1083689533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 029875
- Practice address
- 1311 Milstead Ave NE
Conyers, GA 30012-3829 - Phone
- (770) 483-2368
- Fax
- (770) 785-5080
- NPI assigned
- Feb 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 029875 | GA | Primary |
Addresses
Primary practice location
1311 Milstead Ave NE
Conyers, GA 30012-3829
Mailing address
50 Upland TRL
Oxford, GA 30054-2923
Phone (770) 483-2368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029875 | GA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Metro OB GYN Specialists, Inc | Specialist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Obstetrics & Gynecology Physician
- Covington, GA
- NPI 1588698427
Specialist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1083689533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 UPLAND TRL",
"city": "OXFORD",
"state": "GA",
"postal_code": "300542923",
"telephone_number": "770-483-2368",
"fax_number": "770-785-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 MILSTEAD AVE NE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300123829",
"telephone_number": "770-483-2368",
"fax_number": "770-785-5080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "MICHAEL",
"middle_name": "JEROME",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "029875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.