NPIMap

Organization Active NPI

Grace Family Healthcare

  • Primary Care Clinic/Center
  • Saint Marys, GA
National Provider Identifier
1467017491
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GRACE FAMILY HEALTHCARE
Practice address
102 Lakeshore Dr Ste B
Saint Marys, GA 31558-3875
Phone
(912) 729-2955
Fax
(912) 882-4897
NPI assigned
May 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Authorized official

Name
Angela Dawn Johnson, ARNP
Title
Nurse Practitioner
Phone
(912) 729-2955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

102 Lakeshore Dr Ste B
Saint Marys, GA 31558-3875

Mailing address

102 Lakeshore Dr Ste B
Saint Marys, GA 31558-3875

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1467017491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 LAKESHORE DR STE B",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583875",
            "fax_number": "912-882-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 LAKESHORE DR STE B",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583875",
            "telephone_number": "912-729-2955",
            "fax_number": "912-882-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "912-729-2955",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.