NPIMap

Organization Active NPI

Grace Urological Inc

  • Urology Physician
  • Brattleboro, VT
National Provider Identifier
1699819227
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
420008109 Issued in VT
Legal business name
GRACE UROLOGICAL INC
Practice address
191 Clark Ave
Suite 1
Brattleboro, VT 05301-3400
Phone
(802) 257-4265
Fax
(802) 258-3809
NPI assigned
Feb 16, 2007
Last updated
Apr 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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

Authorized official

Name
John S.F. Daly, M.D.NPI 1235100371
Title
President
Phone
(802) 257-4265

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
Urology Physician 208800000X 420008109 VT Primary

Addresses

Primary practice location

191 Clark Ave
Suite 1
Brattleboro, VT 05301-3400

Mailing address

191 Clark Ave
Suite 1
Brattleboro, VT 05301-3400
Phone (802) 257-4265

Other identifiers 1

IdentifierTypeStateIssuer
0VN0579MedicaidVT

National Provider Directory

National Provider Directory

Locations

382 Canal St
Brattleboro, VT 05301
Phone (802) 257-4265

Practitioners & affiliated clinicians

Practitioners 3

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": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1699819227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 CLARK AVE",
            "address_2": "SUITE 1",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053013400",
            "telephone_number": "802-257-4265",
            "fax_number": "802-258-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 CLARK AVE",
            "address_2": "SUITE 1",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053013400",
            "telephone_number": "802-257-4265",
            "fax_number": "802-258-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE UROLOGICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "DALY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-257-4265",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VT",
            "license": "420008109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN0579",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; 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.