Individual provider Active NPI

Joliette Nicole Grace, M.D.

  • Surgery Physician
  • Rock Hill, SC
National Provider Identifier
1104146133
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME133013 Issued in FL
Practice address
200 Herlong Ave S Ste G
Rock Hill, SC 29732-1182
Phone
(803) 909-6300
Fax
(803) 909-6310
NPI assigned
Jun 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 93469 SC
Surgery Physician 208600000X ME133013 FL Primary
Trauma Surgery Physician 2086S0127X ME133013 FL

Addresses

Primary practice location

200 Herlong Ave S Ste G
Rock Hill, SC 29732-1182

Mailing address

13111 Bridgeport Xing
Bradenton, FL 34211-4002
Phone (573) 703-5663

Other names 1

  • Joliette Nicole Barnum Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241210000052 SC Practitioner - General Surgery 8224336771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Missouri, Columbia School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Physician Network LLCGroup PAC ID 7911287552, 92 clinicians

Practice addresses (Care Compare)

200 Herlong Ave S
Suite G
Rock Hill, SC 29732-1182
Phone (803) 909-6300

Hospital & facility affiliations

  • Piedmont Medical Center Hospital, Rock Hill, SC, CCN 420002

Merit-based Incentive Payment System (MIPS)

Final score
97.62 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
76.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME133013FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Physician Network LLC Surgery CurrentSince Oct 23, 2024 Accepting new patients

Locations

200 Herlong Ave S
Ste G
Rock Hill, SC 29732
Phone (803) 325-1770

200 Herlong Ave S
Ste E
Rock Hill, SC 29732
Phone (803) 324-1950

200 Herlong Ave S
Ste C
Rock Hill, SC 29732
Phone (803) 323-2775

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4
  • Direct secure messaging: joliette.grace.1@14929.direct.athenahealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1104146133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13111 BRIDGEPORT XING",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114002",
            "telephone_number": "573-703-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HERLONG AVE S STE G",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321182",
            "telephone_number": "803-909-6300",
            "fax_number": "803-909-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "JOLIETTE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-01",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "93469",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME133013",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "ME133013",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOLIETTE",
            "last_name": "BARNUM",
            "middle_name": "NICOLE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.