Grace Medical Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

049075 Issued in GA

Legal business name

GRACE MEDICAL CLINIC

Practice address

230 W College St
B
Griffin, GA 30224-4121

Phone

(678) 688-1155

Fax

(678) 688-5071

NPI assigned

Nov 14, 2006

Last updated

Aug 11, 2010By 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

Dr. Ehi Philip Osehobo, M.D.NPI 1639146293

Title

Medical Director

Phone

(678) 688-1155

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ehi Philip Osehobo, MD PHD

  • Internal Medicine Physician
  • Griffin, GA
  • NPI 1639146293
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281484800000",
    "number": "1093887168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W COLLEGE ST",
            "address_2": "B",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244121",
            "telephone_number": "678-688-1155",
            "fax_number": "678-688-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W COLLEGE ST",
            "address_2": "B",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244121",
            "telephone_number": "678-688-1155",
            "fax_number": "678-688-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-08-11",
        "status": "A",
        "authorized_official_last_name": "OSEHOBO",
        "authorized_official_first_name": "EHI",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "678-688-1155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "049075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187778601A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Gordy
• Gore Medical Management (Family Medical Center)
• Kristin M Gore, MD
• Roger Gould, MA
• Appaswamy M Gowda, MD
• Charles Frederick Graci Sr., CRNA
• Greater Biometric Services
• Tracey Greene-Johnson, M.D.
• Griffin Area Resource Center, Inc
• Griffin Center for Pain and Spine

• Internal Medicine Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.