Organization Active NPI

Gracefully Anchored Psychiatry

  • Child & Adolescent Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1174313936
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
GRACEFULLY ANCHORED PSYCHIATRY
Practice address
4600 Beach Blvd
Jacksonville, FL 32207-4764
Phone
(904) 650-3906
NPI assigned
May 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Authorized official

Name
Elisha Greggo, MD
Title
Owner
Phone
(904) 650-3906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

4600 Beach Blvd
Jacksonville, FL 32207-4764

Mailing address

4600 Beach Blvd
Jacksonville, FL 32207-4764
Phone (904) 650-3906

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1174313936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074764",
            "telephone_number": "904-650-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074764",
            "telephone_number": "904-650-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFULLY ANCHORED PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "GREGGO",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-650-3906",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.