Organization Active NPI

Good Graces

Doing business as Good Graces Pharmacy

  • Long Term Care Pharmacy
  • Willow Springs, MO
National Provider Identifier
1174273114
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GOOD GRACES
Doing business as
Good Graces Pharmacy
Practice address
857 E Main St Ste 3
Willow Springs, MO 65793-1500
Phone
(417) 855-1085
Fax
(417) 855-1086
NPI assigned
Mar 24, 2022
Last updated
Jul 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Dr. Brandon GregoryNPI 1508113705
Title
Co-Owner, President
Phone
(417) 855-1085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

857 E Main St Ste 3
Willow Springs, MO 65793-1500

Mailing address

857 E Main St Ste 3
Willow Springs, MO 65793-1500
Phone (417) 855-1085

Other identifiers 2

IdentifierTypeStateIssuer
1265033534OtherNPI
600092646MedicaidMO

Other names 2

  • Good Graces Pharmacy Doing business as
  • Good Graces LTC Other name

National Provider Directory

National Provider Directory

Locations

857 E Main St
Ste 3
Willow Springs, MO 65793
Phone (417) 855-0428

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1174273114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 E MAIN ST STE 3",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657931500",
            "telephone_number": "417-855-1085",
            "fax_number": "417-855-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 E MAIN ST STE 3",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657931500",
            "telephone_number": "417-855-1085",
            "fax_number": "417-855-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD GRACES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CO-OWNER, PRESIDENT",
        "authorized_official_telephone_number": "417-855-1085",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1265033534",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600092646",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Graces Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Good Graces LTC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Willow Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.