Gracie D Vergara, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101056502 Issued in VA

Practice address

1005 Commercial LN
Suite 220
Suffolk, VA 23434-8149

Phone

(757) 668-2600

Fax

(757) 668-2620

NPI assigned

Mar 31, 2006

Last updated

Nov 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gracie D Bernardo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: gracie.vergara.1@6174.direct.athenahealth.com

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.

• Childrens Medical Group Inc

  dba Nansemond Pediatrics

  • Pediatrics Physician
  • Suffolk, VA
  • NPI 1144468836
  NPD (past)
• Childrens Medical Group Inc

  dba General Booth Pediatrics

  • Pediatrics Physician
  • Virginia Beach, VA
  • NPI 1366597114
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1538120290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 COMMERCIAL LN",
            "address_2": "SUITE 220",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348149",
            "telephone_number": "757-668-2600",
            "fax_number": "757-668-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 COMMERCIAL LN",
            "address_2": "SUITE 220",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348149",
            "telephone_number": "757-668-2600",
            "fax_number": "757-668-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "GRACIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101056502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891154T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACIE",
            "last_name": "BERNARDO",
            "middle_name": "D",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Vaughn, PA-C
• Velocity Urgent Care, LLC (Velocity Urgent Care)
• Velocity Urgent Care, LLC (Velocity Urgent Care)
• Venus Watkins (Absolute Transport Service)
• Joseph Lorenzo Verdirame, MD
• Veteran Care Providers
• Veterans Care Providers
• Joshua Landon Vick, LPTA
• Victorious Angels Home Healthcare LLC.
• Vidal Care Residency LLC

• Pediatrics Physician in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.