Active NPI
Ronald Grace II, PSYD
- Clinical Psychologist
- Annapolis, MD
National Provider Identifier
1366858698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 05416
- Practice address
- 49 Old Solomons Island Rd
Suite 303
Annapolis, MD 21401-3854 - Phone
- (410) 757-2077
- NPI assigned
- Jul 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 05416 | MD | Primary |
Addresses
Primary practice location
49 Old Solomons Island Rd
Suite 303
Annapolis, MD 21401-3854
Mailing address
1320 N Veitch St
Apt 805
Arlington, VA 22201-6221
Phone (304) 444-2928
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05416 | MD | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PM Management - Cedar Park NC LLC | Past | Accepting new patients |
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.
-
- Skilled Nursing Facility
- Cedar Park, TX
- NPI 1548527963
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404777600000",
"number": "1366858698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 N VEITCH ST",
"address_2": "APT 805",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222016221",
"telephone_number": "304-444-2928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 OLD SOLOMONS ISLAND RD",
"address_2": "SUITE 303",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214013854",
"telephone_number": "410-757-2077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "RONALD",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-08",
"last_updated": "2014-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.