Grace Lee Henninger, MD

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

2018-00052 Issued in NC

Practice address

126 Executive Dr Ste 110
Wilkesboro, NC 28697-7588

Phone

(336) 818-3177

Fax

(336) 667-2213

NPI assigned

Jun 16, 2008

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Grace Shou-Chian Lee Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Home Care of Vance County, LLC

  dba Gentiva

  • Community Based Hospice Care Agency
  • Henderson, NC
  • NPI 1841247335
  NPD (past)

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477713188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 EXECUTIVE DR STE 110",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286977588",
            "telephone_number": "336-818-2177",
            "fax_number": "336-667-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 EXECUTIVE DR STE 110",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286977588",
            "telephone_number": "336-818-3177",
            "fax_number": "336-667-2213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Naval Health Clinic Cherry Point",
            "address_2": "4389 Beaufort Road",
            "address_purpose": "LOCATION",
            "city": "Cherry Point",
            "state": "NC",
            "postal_code": "28533",
            "country_code": "US",
            "telephone_number": "252-455-0266",
            "fax_number": "252-466-0127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Naval Health Clinic Cherry Point",
            "address_2": "4389 Beaufort Road",
            "address_purpose": "LOCATION",
            "city": "Cherry Point",
            "state": "NC",
            "postal_code": "28533",
            "country_code": "US",
            "telephone_number": "252-455-0266",
            "fax_number": "252-466-0127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1370 W D St",
            "address_purpose": "LOCATION",
            "city": "North Wilkesboro",
            "state": "NC",
            "postal_code": "28659",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1308 Davie Ave",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286773514",
            "country_code": "US",
            "telephone_number": "704-871-8036",
            "fax_number": "855-240-5458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNINGER",
        "first_name": "GRACE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2022-07-21",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A110582",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2018-00052",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "2018-00052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "LEE",
            "middle_name": "SHOU-CHIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Hospice and Palliative Medicine (Internal Medicine) Physician in Wilkesboro, NC
• Providers in Wilkesboro, NC by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.