Organization Active NPI

Graceon Family and Womens Clinic LLC

  • Primary Care Clinic/Center
  • Greenbelt, MD
National Provider Identifier
1477283620
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GRACEON FAMILY AND WOMENS CLINIC LLC
Practice address
7315 Hanover Pkwy Ste 1B
Greenbelt, MD 20770-2035
Phone
(240) 965-7141
Fax
(240) 965-7164
NPI assigned
Jun 12, 2022
Last updated
Sep 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Authorized official

Name
Dr. Victoria Ngozi Ogbuji, FNPNPI 1598252561
Title
Medical Director
Phone
(240) 965-7141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

7315 Hanover Pkwy Ste 1B
Greenbelt, MD 20770-2035

Mailing address

7315 Hanover Pkwy Ste 1B
Greenbelt, MD 20770-2035
Phone (240) 965-7141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221013003782 DC Part B Supplier - Clinic/Group Practice 2860868957 Receives reassigned benefits from 1 practitioner
Practice locations: New Carrollton, MD

National Provider Directory

National Provider Directory

Locations

7315 Hanover Pkwy
Ste 1B
Greenbelt, MD 20770
Phone (240) 965-7141

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1477283620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 HANOVER PKWY STE 1B",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702035",
            "telephone_number": "240-965-7141",
            "fax_number": "240-965-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 HANOVER PKWY STE 1B",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702035",
            "telephone_number": "240-965-7141",
            "fax_number": "240-965-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEON FAMILY AND WOMENS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "OGBUJI",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "NGOZI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "240-965-7141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.