Graceol Corporation

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

GRACEOL CORPORATION

Practice address

1035 Honey Creek Rd
Conyers, GA 30013

Phone

(404) 839-2688

Fax

(770) 922-9498

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Yemi J. Sowemimo, FNP-C

Title

Owner

Phone

(404) 839-2688

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1306373188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 HONEY CREEK ROAD",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30013",
            "telephone_number": "404-839-2688",
            "fax_number": "770-922-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 HONEY CREEK RD",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30013",
            "telephone_number": "404-839-2688",
            "fax_number": "770-922-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEOL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SOWEMIMO",
        "authorized_official_first_name": "YEMI",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-839-2688",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639177066",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912016411",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790107381",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Alan Gordon, M.D.
• Stephanie H Gordon, M.D.
• Kelly Denise Gorham, LPC
• Maria Goyco, M.D.
• Graceful Serenity Counseling LLC
• Graceol Counseling Center Inc
• Michael Jerome Grady, D.O.
• Catonya Graham
• Latoya Grandy-Walker, LCSW
• Jody Lee Granier, DDS

• Adult Medicine Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Adult Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.