Individual provider Active NPI

Camille Lynn Grace, DPT

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1184335200
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30019 Issued in MD
Practice address
10700 Charter Dr Ste 205
Columbia, MD 21044-3687
Phone
(443) 546-1575
Fax
(443) 546-1575
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20481 CO
Physical Therapist 225100000X 30019 MD Primary

Addresses

Primary practice location

10700 Charter Dr Ste 205
Columbia, MD 21044-3687

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004

Other practice location 1

660 Golden Ridge Rd Ste 130
Golden, CO 80401-9541
Phone (720) 497-6616

Other practice location 2

4924 Campbell Blvd Ste 130A
Nottingham, MD 21236-5909
Phone (443) 997-5476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250409003001 CO Practitioner - Physical Therapist in Private Practice 5496283012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Luna Care Physical Therapy LLCGroup PAC ID 7517363617, 210 clinicians
Panorama Orthopedics and Spine Center PCGroup PAC ID 8426961087, 316 clinicians

Practice addresses (Care Compare)

Denver, CO 80246
Phone (866) 525-3175

660 Golden Ridge Rd
Suite 130
Golden, CO 80401-9541
Phone (720) 497-6616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30019MDMDPharmacist
20481COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince May 20, 2025 Accepting new patients
Colorado Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 20, 2025 Accepting new patients
Panorama Orthopedics & Spine Center, PC CurrentSince Apr 4, 2025 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince May 20, 2025 Accepting new patients
Panorama Orthopedics & Spine Center, PC CurrentSince Apr 4, 2025 Accepting new patients
Panorama Orthopedics and Spine Center PC Current Accepting new patients

Locations

500 Eldorado Blvd
Bldg 4
Broomfield, CO 80021
Phone (303) 812-4790

501 S Cherry St
Fl 11
Denver, CO 80246
Phone (309) 530-8782

660 Golden Ridge Rd
Ste 250
Golden, CO 80401
Phone (303) 274-7321

660 Golden Ridge Rd
Ste 130
Golden, CO 80401
Phone (303) 275-2190

8550 W 38th Ave
Ste 100
Wheat Ridge, CO 80033
Phone (303) 467-4100

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1184335200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "fax_number": "720-497-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 CHARTER DR STE 205",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443687",
            "telephone_number": "443-546-1575",
            "fax_number": "443-546-1575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 Golden Ridge Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "804019541",
            "country_code": "US",
            "telephone_number": "720-497-6616",
            "fax_number": "720-497-6767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4924 Campbell Blvd Ste 130A",
            "address_purpose": "LOCATION",
            "city": "Nottingham",
            "state": "MD",
            "postal_code": "212365909",
            "country_code": "US",
            "telephone_number": "443-997-5476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACE",
        "first_name": "CAMILLE",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "20481",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.