Gracemore, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10631320 Issued in GA

Legal business name

GRACEMORE, LLC

Practice address

2708 Lee St
Brunswick, GA 31520-4932

Phone

(912) 265-6771

Fax

(912) 264-8988

NPI assigned

Oct 18, 2005

Organization subpart

No

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

Authorized official

Name

Mr. William C. Davis Jr.

Title

President

Phone

(478) 988-1294

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Skilled nursing facility certification: CCN 115554

Legal name

GRACEMORE LLC

Doing business as

GRACEMORE NURSING & REHAB

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 1993

Last certification

Mar 9, 2025

Beds

60

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

2708 Lee St
Brunswick, GA 31520-4932

Nursing home name

GRACEMORE NURSING AND REHAB

Affiliated entity

CROSSROADS MEDICAL MANAGEMENT

Listed as

Gracemore Nursing and RehabCCN 115554

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Oct 1, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6040.9 residents per day on average

Chain

Crossroads Medical Management6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Appavuchetty Soundappan, MD

  • Internal Medicine Physician
  • Perry, GA
  • NPI 1912951500

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

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

• Appavuchetty Soundappan, MD

  • Internal Medicine Physician
  • Perry, GA
  • NPI 1912951500
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Appavuchetty Soundappan, MD

  • Internal Medicine Physician
  • Perry, GA
  • NPI 1912951500

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1477542991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 MACON RD",
            "address_2": "STE D",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310692679",
            "telephone_number": "478-988-1294",
            "fax_number": "478-988-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 LEE ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204932",
            "telephone_number": "912-265-6771",
            "fax_number": "912-264-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEMORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-988-1294",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "10631320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000141182B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000141182A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Goss, RN
• Tiffany Cherie Gossett, LPC
• James Furman Gowen, M.D.
• Shanterra Grable, PHARMD
• Grace and Growth Behavioral Services
• Gracious Care Recovery Solutions Inc
• Yoshi T Graham, FNP-C
• Grace Greene, RN
• James Walter Greene, MD
• Joe Stephen Greene, M.D.

• Skilled Nursing Facility in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.