Active NPI
Rene Earle Grace, M.D.
- General Practice Physician
- Clinton, MD
National Provider Identifier
1578686291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- D002259
- Practice address
- 7503 Surratts Road
Clinton, MD 20675 - Phone
- (301) 994-3366
- NPI assigned
- Apr 9, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | D002259 | MD | Primary |
Addresses
Primary practice location
7503 Surratts Road
Clinton, MD 20675
Mailing address
P.O. Box 250
Piney Point, MD 20674
Phone (301) 994-3366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D002259 | MD | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578686291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 250",
"city": "PINEY POINT",
"state": "MD",
"postal_code": "20674",
"telephone_number": "301-994-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7503 SURRATTS ROAD",
"city": "CLINTON",
"state": "MD",
"postal_code": "20675",
"telephone_number": "301-994-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "RENE",
"middle_name": "EARLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MD",
"license": "D002259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.