Individual provider Active NPI

John F Grace, PSY.D

  • Psychologist
  • Athens, GA
National Provider Identifier
1487799664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
003032 Issued in GA
Practice address
1 Huntington Rd Ste 801
Athens, GA 30606-7216
Phone
(706) 552-0450
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 003032 GA Primary

Addresses

Primary practice location

1 Huntington Rd Ste 801
Athens, GA 30606-7216

Mailing address

3101 Peachtree Park Dr NE
Atlanta, GA 30309-1340
Phone (404) 545-4220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121107000671 GA Practitioner - Clinical Psychologist 6507961075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Huntingdon Rd
Suite 801
Athens, GA 30606
Phone (706) 552-0450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003032GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Psychotherapy & Psychological Assesment Services of North Ga CurrentSince Jan 1, 2011 Accepting new patients

Locations

1 Huntington Rd
Ste 801
Athens, GA 30606
Phone (706) 552-0450

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487799664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 PEACHTREE PARK DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091340",
            "telephone_number": "404-545-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HUNTINGTON RD STE 801",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306067216",
            "telephone_number": "706-552-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "JOHN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "003032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.