By Grace Medical Group, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BY GRACE MEDICAL GROUP, LLC

Practice address

1001-1003 E Patapsco Ave
Baltimore, MD 21225

Phone

(443) 694-8208

NPI assigned

Apr 6, 2021

Last updated

Apr 6, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Pamela Dukes

Title

Owner

Phone

(443) 694-8208

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1679152763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001-1003 E PATAPSCO AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21225",
            "telephone_number": "443-694-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001-1003 E PATAPSCO AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21225",
            "telephone_number": "443-694-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BY GRACE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "DUKES",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-694-8208",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.