Individual provider Active NPI

Grace Gramley, M.D.

  • Internal Medicine Physician
  • Wilmington, NC
National Provider Identifier
1104805928
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
98-00716 Issued in NC
Practice address
1912 Meeting CT
Wilmington, NC 28401-6631
Phone
(910) 342-0096
Fax
(910) 342-0097
NPI assigned
Jan 10, 2006
Last updated
Jan 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 98-00716 NC Primary

Addresses

Primary practice location

1912 Meeting CT
Wilmington, NC 28401-6631

Mailing address

1912 Meeting CT
Wilmington, NC 28401-6631
Phone (910) 342-0096

Other identifiers 1

IdentifierTypeStateIssuer
891162XMedicaidNC

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914000133 NC Practitioner - Internal Medicine 8325163454 Practice locations: Wilmington, NC

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98-00716NCMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1104805928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 MEETING CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016631",
            "telephone_number": "910-342-0096",
            "fax_number": "910-342-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 MEETING CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016631",
            "telephone_number": "910-342-0096",
            "fax_number": "910-342-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMLEY",
        "first_name": "GRACE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "98-00716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891162X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.