Grace Medical Services LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

GRACE MEDICAL SERVICES LLC

Practice address

6600 York Rd Ste 200B
Baltimore, MD 21212-2024

Phone

(443) 275-1031

Fax

(443) 275-2597

NPI assigned

May 20, 2021

Last updated

May 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Agatha N Ukaegbu, MSNNPI 1346752433

Title

Owner of Entity

Phone

(443) 275-1031

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Tax ID family

Grace Medical Services 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 Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1346815180
  NPD tax ID

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.

• Agatha N Ukaegbu, NP

  • Primary Care Nurse Practitioner
  • Rosedale, MD
  • NPI 1346752433
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1487229639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 YORK RD STE 200B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122024",
            "telephone_number": "443-275-1031",
            "fax_number": "443-275-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 YORK RD STE 200B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122024",
            "telephone_number": "443-275-1031",
            "fax_number": "443-275-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "UKAEGBU",
        "authorized_official_first_name": "AGATHA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "443-275-1031",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Medical Center, Inc.
• Grace Medical Center, Inc.
• Grace Medical Center, Inc.
• Grace Medical Center, Inc.
• Grace Medical Services LLC
• Grace Medical Supplies Inc.
• Grace Outreach Adc
• Candice D Grace-Lee, M.D.
• Annie Kathleen Grace, CRNP
• Mary Teresa Grace, CPNP

• Primary Care Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.