Active NPI
Harrison Elliott Grace, MD, PHD
- Student in an Organized Health Care Education/Training Program
- Albuquerque, NM
National Provider Identifier
1104440858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1 University of New Mexico # 105590
Albuquerque, NM 87131-2165 - Phone
- (505) 272-5551
- NPI assigned
- May 28, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | NM | Primary |
Addresses
Primary practice location
1 University of New Mexico # 105590
Albuquerque, NM 87131-2165
Mailing address
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-6225
Other practice location 1
1500 Oglethorpe Ave Ste 200D
Athens, GA 30606-2165
Phone (706) 389-3875
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1104440858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 UNIVERSITY OF NEW MEXICO",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001",
"telephone_number": "505-272-6225",
"fax_number": "505-272-5184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 UNIVERSITY OF NEW MEXICO # 105590",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871312165",
"telephone_number": "505-272-5551"
}
],
"practiceLocations": [
{
"address_1": "1500 Oglethorpe Ave Ste 200D",
"address_purpose": "LOCATION",
"city": "Athens",
"state": "GA",
"postal_code": "306062165",
"country_code": "US",
"telephone_number": "706-389-3875",
"fax_number": "706-389-3876",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRACE",
"first_name": "HARRISON",
"middle_name": "ELLIOTT",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-28",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.