Active NPI
William Grace, D.O.
- Family Medicine Physician
- Cadillac, MI
National Provider Identifier
1386646487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- WG008586
- Practice address
- 827 E Division St
Cadillac, MI 49601-2015 - Phone
- (231) 775-9741
- Fax
- (231) 775-9333
- NPI assigned
- Aug 10, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | WG008586 | MI | Primary |
Addresses
Primary practice location
827 E Division St
Cadillac, MI 49601-2015
Mailing address
827 E Division St
Cadillac, MI 49601-2015
Phone (231) 775-9741
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0858300835 | Other | MI | BLUE CROSS/SHIELD IDIVIDU |
| 010014533 | Other | MI | RAILROAD MEDICARE |
| 0H36303 | Other | MI | BLUE CROSS/SHIELD GROUP |
| 101933 | Other | MI | PREFERRED CHOICE ID |
| 3083482 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WG008586 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1386646487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "827 E DIVISION ST",
"city": "CADILLAC",
"state": "MI",
"postal_code": "496012015",
"telephone_number": "231-775-9741",
"fax_number": "231-775-9333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "827 E DIVISION ST",
"city": "CADILLAC",
"state": "MI",
"postal_code": "496012015",
"telephone_number": "231-775-9741",
"fax_number": "231-775-9333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2016-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "WG008586",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/SHIELD IDIVIDU",
"identifier": "0858300835",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "010014533",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/SHIELD GROUP",
"identifier": "0H36303",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CHOICE ID",
"identifier": "101933",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3083482",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cadillac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.