Gracia De Jong, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35.141481 Issued in OH

Practice address

55 Clairedan Dr
Powell, OH 43065-8064

Phone

(614) 888-8989

Fax

(614) 888-8968

NPI assigned

Apr 1, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gdejong19149@copcp.medicity.net

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.

• Nationwide Children'S Hospital

  • Multi-Specialty Clinic/Center
  • Columbus, OH
  • NPI 1851179873

  Pediatrics

  Medicare reassignment NPD
• Pediatric Academic Association, Inc.

  • Pediatrics Physician
  • Columbus, OH
  • NPI 1063419943
  Medicare reassignment NPD
• Central Ohio Primary Care Physicians Inc

  • Hospitalist Physician
  • Westerville, OH
  • NPI 1518398866
  NPD
• Nationwide Children'S Hospital

  • Durable Medical Equipment & Medical Supplies
  • Columbus, OH
  • NPI 1447061262
  NPD
• Central Ohio Primary Care Physicians, Inc.

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1194705194

  Pediatrics

  NPD (past)
• Nationwide Children'S Hospital

  • Dental Clinic/Center
  • Columbus, OH
  • NPI 1407013964
  NPD (past)
• Powell Pediatric Care

  • Pediatrics Physician
  • Powell, OH
  • NPI 1801961057
  NPD (past)

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

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1154827061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CLAIREDAN DR",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658064",
            "telephone_number": "614-888-8989",
            "fax_number": "614-888-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CLAIREDAN DR",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658064",
            "telephone_number": "614-888-8989",
            "fax_number": "614-888-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JONG",
        "first_name": "GRACIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-01",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.141481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGS MEDICARE",
            "identifier": "H771400",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0435440",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melvin H Davis
• Davison Orthodontics
• Erin Davison
• Lisa Marie Davison, DDS
• Ava Marie Dawley
• Mark E Degarmo, P.T., D.P.T.
• Cora Lee Delpercio, L.P.N.
• Marilyn Dennis
• Dennison & Associates Inc.
• Barbara Jo Dennison, PHD, LISW

• Pediatrics Physician in Powell, OH
• Providers in Powell, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.

Verify at the official NPI Registry.