Individual provider Active NPI

Grace Kelly Vallejo, MD

  • Psychiatry Physician
  • West Columbia, SC
National Provider Identifier
1215564349
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301512093 Issued in MI
Practice address
146 E Hospital Dr Ste 120a
West Columbia, SC 29169-4800
Phone
(803) 936-7460
Fax
(803) 936-7462
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 93769 SC
Neurology Physician 2084N0400X 71490 TN
Psychiatry Physician 2084P0800X 4301512093 MI Primary

Addresses

Primary practice location

146 E Hospital Dr Ste 120a
West Columbia, SC 29169-4800

Mailing address

PO Box 405827
Atlanta, GA 30384-5827

Other practice location 1

1700 Medical Center Pkwy
Murfreesboro, TN 37129-2245
Phone (615) 396-4100

Other practice location 2

1 Ford Pl Ste 1C
Detroit, MI 48202-3450
Phone (313) 874-6677

Other practice location 3

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-7708

Other practice location 4

4000 Wellness Dr
Midland, MI 48670-2113
Phone (989) 839-3538

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gvallejo188396@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TN, MO, SC, MS, WY, WV, AR, GA, AL, NY, OK, WI, LA14 enrollments
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 14

Enrollment IDStateProvider typePAC IDDetails
I20240613003920 MI Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization
I20241022004632 TN Practitioner - Psychiatry 0547703993 Reassigns benefits to 3 organizations
I20250131001714 MO Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization
I20250217000089 SC Practitioner - Psychiatry 0547703993 Reassigns benefits to 5 organizations
I20250705000075 MS Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization
I20251031002221 WY Practitioner - Psychiatry 0547703993 Reassigns benefits to 4 organizations
I20251105004251 WV Practitioner - Psychiatry 0547703993 Reassigns benefits to 2 organizations
I20251202001648 AR Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization
I20251219001771 GA Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization
I20260102000331 AL Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization
I20260113002070 NY Practitioner - Psychiatry 0547703993 Reassigns benefits to 7 organizations
I20260330004039 OK Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization
I20260414003819 WI Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization
I20260415003486 LA Practitioner - Psychiatry 0547703993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cookeville Regional Medical CenterGroup PAC ID 7810805736, 51 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians
McLeod Regional Medical Center of the Pee Dee IncGroup PAC ID 7416851852, 401 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 783-2497

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1700 Medical Ctr Pkwy
Murfreesboro, TN 37129-2245
Phone (615) 396-4685

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35338WVMDSchool Registered Nurse
71490TNMDNeurology Physician
4301512093MIMDPsychiatry Physician
93769SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
McLeod Medical Center-Dillon CurrentSince Oct 1, 2025 Accepting new patients
New York University CurrentSince Dec 7, 2025 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Oct 1, 2025 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Nov 28, 2024 Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2025 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Neurology CurrentSince Oct 1, 2025 Accepting new patients
Cookeville Regional Medical Center CurrentSince Mar 4, 2025 Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Saint Thomas Medical Partners Neurology CurrentSince Oct 1, 2024 Accepting new patients
Lake Regional Health System CurrentSince Mar 1, 2025 Accepting new patients
McLeod Health Clarendon CurrentSince Oct 1, 2025 Accepting new patients
Cookeville Regional Medical Center CurrentSince Mar 4, 2025 Accepting new patients
Baptist Memorial Medical Group Inc Psychiatry CurrentSince Nov 28, 2024 Accepting new patients
Henry Ford Health System CurrentSince Jul 8, 2024 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Oct 1, 2025 Accepting new patients
Lake Regional Health System Current Accepting new patients
St Josephs Hospital of Buckhannon Inc CurrentSince Oct 14, 2025 Accepting new patients
McLeod Health Clarendon CurrentSince Oct 1, 2025 Accepting new patients
Lexington Health Inc Current Accepting new patients
New York University CurrentSince Dec 7, 2025 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Oct 1, 2025 Accepting new patients
McLeod Medical Center-Dillon CurrentSince Oct 1, 2025 Accepting new patients
Memorial Hospital of Carbon County CurrentSince Sep 4, 2025 Accepting new patients
Memorial Hospital of Carbon County CurrentSince Sep 4, 2025 Accepting new patients
Lake Regional Health System CurrentSince Mar 1, 2025 Accepting new patients
Henry Ford Health System Psychiatry CurrentSince Jul 8, 2024 Accepting new patients
Floyd Physicians, LLC Neurology CurrentSince Oct 18, 2025 Accepting new patients
Memorial Hospital of Sweetwater County CurrentSince Oct 1, 2025 Accepting new patients
Lexington Health Inc Psychiatry CurrentSince Feb 1, 2025 Accepting new patients
Long Island Community Hospital at NYU Langone Health Past Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations (25 of 33)

400 Northwood Dr
Centre, AL 35960
Phone (256) 927-1382

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

1 Ford Pl
Ste 1C
Detroit, MI 48202
Phone (313) 874-3094

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

54 Hospital Dr
Ste 201
Osage Beach, MO 65065
Phone (573) 302-2764

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

2520 5th St N
Columbus, MS 39705
Phone (662) 224-1000

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

146 E Hospital Dr
Ste 120A
West Columbia, SC 29169
Phone (803) 936-7076

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

350 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 226-4003

1700 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 396-4100

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: gvallejo1054835@direct.hfhs.org
  • Direct secure messaging: gvallejo775135@nyumc.direct-ci.com

Organizations & group practices 42

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.

View all 42

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1215564349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 E HOSPITAL DR STE 120A",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694800",
            "telephone_number": "803-936-7460",
            "fax_number": "803-936-7462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371292245",
            "country_code": "US",
            "telephone_number": "615-396-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Ford Pl Ste 1C",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482023450",
            "country_code": "US",
            "telephone_number": "313-874-6677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114182832",
            "country_code": "US",
            "telephone_number": "718-206-7708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Wellness Dr",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486702113",
            "country_code": "US",
            "telephone_number": "989-839-3538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "GRACE",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "93769",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "71490",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301512093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gvallejo188396@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "146 E Hospital Dr Ste 120A",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.