Grace Medical Practice LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

GA061309 Issued in GA

Legal business name

GRACE MEDICAL PRACTICE LLC

Practice address

3885 Princeton Lakes Way SW
Suite 402
Atlanta, GA 30331-5589

Phone

(404) 349-0496

NPI assigned

Jan 7, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Fidelia OsinubiNPI 1013194661

Title

Physician

Phone

(404) 861-0291

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Grace Medical Practice LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grace Medical Practice LTD

  • Family Medicine Physician
  • East Point, GA
  • NPI 1396070744
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fidelia O Osinubi, MD

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013194661
  NPD (past) Authorized official

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1407186877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20156",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303250156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 PRINCETON LAKES WAY SW",
            "address_2": "SUITE 402",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315589",
            "telephone_number": "404-349-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-07",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "OSINUBI",
        "authorized_official_first_name": "FIDELIA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "404-861-0291",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "GA061309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Scott Grabowski, MSN, CPNP- AC/PC
• Grace Angels Home Care Corp.
• Grace Anthony Counseling, LLC
• Grace Community Counseling & Social Services, LLC
• Grace E Wu DDS PC
• Grace S. Gavric, DDS, LLC.
• Grace Supportive Living Services LLC
• Zina Nia Grace
• Graced Hands Surgical Assisting
• Graceen Health Services LLC

• Primary Care Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.