Individual provider Active NPI

Grace So

  • Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1245196716
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R231800 Issued in MD
Practice address
6334 Cedar LN Ste 103
Columbia, MD 21044-4172
Phone
(310) 531-2355
NPI assigned
Dec 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R231800 MD Primary

Addresses

Primary practice location

6334 Cedar LN Ste 103
Columbia, MD 21044-4172

Mailing address

6334 Cedar LN Ste 103
Columbia, MD 21044-4172
Phone (410) 531-2355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260306003644 MD Practitioner - Nurse Practitioner 4880176809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Maryland School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Physician Care, LLCGroup PAC ID 3274683289, 13 clinicians

Practice addresses (Care Compare)

6334 Cedar LN
Suite 103
Columbia, MD 21044-4172
Phone (410) 531-2355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R231800MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Physician Care, LLC CurrentSince Feb 24, 2026 Accepting new patients

Locations

6334 Cedar Ln
Ste 103
Columbia, MD 21044
Phone (410) 531-2355

Organizations & group practices 1

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": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1245196716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6334 CEDAR LN STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210444172",
            "telephone_number": "410-531-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6334 CEDAR LN STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210444172",
            "telephone_number": "310-531-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R231800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.