Gwendolyn Gregory Grace, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DR.47860 Issued in CO

Practice address

75 Manhattan Dr
Suite 204
Boulder, CO 80303-4254

Phone

(303) 569-8858

Fax

(303) 647-9214

NPI assigned

Jul 23, 2007

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 names 1

• Dr. Gwendolyn Gregory Greer Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Psychiatry

Education

Wright State University Boonshoft School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rocky Mountain Psychiatric Associates. LLCGroup PAC ID 7416327788, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rocky Mountain Psychiatric Associates, LLC

  • Psychiatry Physician
  • Boulder, CO
  • NPI 1023726825
  Medicare reassignment Care Compare group NPD Authorized official
• Boulder Community Health

  • Primary Care Clinic/Center
  • Boulder, CO
  • NPI 1740837137
  NPD (past)

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1194925594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MANHATTAN DR",
            "address_2": "SUITE 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034254",
            "telephone_number": "303-569-8858",
            "fax_number": "303-647-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MANHATTAN DR",
            "address_2": "SUITE 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034254",
            "telephone_number": "303-569-8858",
            "fax_number": "303-647-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "GWENDOLYN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.47860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWENDOLYN",
            "last_name": "GREER",
            "middle_name": "GREGORY",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Regina Marsha Gould, MA,CCC-A
• Marc Jason Goulet, MA, NCC, LPCC
• Maxine Anne Gower
• Jordan Gozdzialski, M.D.
• GR8 Alchemy
• Graceful Movement Center for Feldenkrais and Physical Therapy
• Gracious Growth Colorado LLC
• Brian P Gradisek, D.P.M.
• Colleen Mary Grady Yuskewich, OTR
• James R Grady, M.D.

• Psychiatry Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.
• 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.