NPIMap

Organization Active NPI

By Grace

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
National Provider Identifier
1194990770
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
102166 Issued in MD
Legal business name
BY GRACE
Practice address
1000-1004 E Patapsco Ave
Baltimore, MD 21225-2229
Phone
(410) 355-3711
Fax
(410) 355-2350
NPI assigned
Apr 24, 2008
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Pamela Dukes, MHS,CAC-ADNPI 1043483472
Title
Owner
Phone
(443) 831-0191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 102166 MD Primary

Addresses

Primary practice location

1000-1004 E Patapsco Ave
Baltimore, MD 21225-2229

Mailing address

PO Box 2727
Baltimore, MD 21225-0727
Phone (410) 355-3711

Other practice location 1

1002 E Patapsco Ave
Baltimore, MD 21225-2229
Phone (103) 553-7114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Opioid treatment program
Medicare-enrolled since Mar 18, 2021

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210715000511 MD Part B Supplier - Opioid Treatment Program (Otp) 8022410927 Practice locations: Brooklyn, MD

National Provider Directory

National Provider Directory
Tax ID family
By Grace4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

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": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1194990770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2727",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212250727",
            "telephone_number": "410-355-3711",
            "fax_number": "410-355-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000-1004 E PATAPSCO AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212252229",
            "telephone_number": "410-355-3711",
            "fax_number": "410-355-2350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 E Patapsco Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212252229",
            "country_code": "US",
            "telephone_number": "103-553-7114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BY GRACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-16",
        "status": "A",
        "authorized_official_last_name": "DUKES",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-831-0191",
        "authorized_official_credential": "MHS,CAC-AD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "102166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.