Grace Family Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GRACE FAMILY MEDICAL CENTER

Practice address

3849 North Blvd
Suite 100
Baton Rouge, LA 70806-3854

Phone

(225) 381-6765

Fax

(225) 381-6767

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Alencia Clayton Ellis, PANPI 1407893654

Title

Physician Assistant

Phone

(225) 381-6765

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alencia C Ellis, P.A.

  • Physician Assistant
  • Baton Rouge, LA
  • NPI 1407893654
  NPD (past) Authorized official
• Nedra Clem Jackson, M.D.

  • Family Medicine Physician
  • West Memphis, AR
  • NPI 1659477164
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598896961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24438 PLANK RD",
            "city": "SLAUGHTER",
            "state": "LA",
            "postal_code": "707779701",
            "telephone_number": "225-381-6765",
            "fax_number": "225-381-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3849 NORTH BLVD",
            "address_2": "SUITE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063854",
            "telephone_number": "225-381-6765",
            "fax_number": "225-381-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ALENCIA",
        "authorized_official_middle_name": "CLAYTON",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "225-381-6765",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Govan
• Tijah Governor
• Dana Goza, PT
• Grace and Glory Adhc
• Grace Care LLC
• Grace for Grace Personal Care Services
• Grace Healthcare Incorporated
• Grace House of Baton Rouge, Inc.
• Grace Kidney Care
• Grace Therapy Center, LLC

• Family Medicine Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.