Organization Active NPI

Medicine With Mercy and Grace

  • Clinic/Center
  • Shelby, NC
National Provider Identifier
1508398553
Registry record updated Feb 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
200000527 Issued in NC
Legal business name
MEDICINE WITH MERCY AND GRACE
Practice address
210 W Dale St
Shelby, NC 28150
Phone
(980) 295-9862
Fax
(704) 466-3494
NPI assigned
Mar 29, 2017
Last updated
Feb 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2021

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

Authorized official

Name
Rebecca Jean Love, M.D.NPI 1376594424
Title
President
Phone
(980) 295-9862

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 200000527 NC Primary

Addresses

Primary practice location

210 W Dale St
Shelby, NC 28150

Mailing address

201 S Washington St Apt 401
Shelby, NC 28150-2617
Phone (980) 295-9862

Other identifiers 1

IdentifierTypeStateIssuer
89126G9MedicaidNC

National Provider Directory

National Provider Directory

Locations

210 W Dale St
Shelby, NC 28150
Phone (980) 295-9862

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": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613779200000",
    "number": "1508398553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S WASHINGTON ST APT 401",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281502617",
            "telephone_number": "980-295-9862",
            "fax_number": "704-406-9897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W DALE ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28150",
            "telephone_number": "980-295-9862",
            "fax_number": "704-466-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE WITH MERCY AND GRACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "980-295-9862",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "200000527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126G9",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.