Grace Medical and Wellness Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GRACE MEDICAL AND WELLNESS CENTER, LLC

Practice address

3772 Satellite Blvd Ste 204
Duluth, GA 30096-5681

Phone

(470) 885-8080

Fax

(470) 885-8088

NPI assigned

Aug 6, 2020

Last updated

Sep 6, 2023By 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

Wendy Fragoso

Title

Director

Phone

(470) 885-8080

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: info@mygracemedical.com

Practitioners 1

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.

• Wendy Ledesma, PA

  • Medical Physician Assistant
  • Duluth, GA
  • NPI 1043423510
  NPD

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1720698426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3772 SATELLITE BLVD STE 204",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965681",
            "telephone_number": "470-885-8080",
            "fax_number": "470-885-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 SATELLITE BLVD STE 204",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965681",
            "telephone_number": "470-885-8080",
            "fax_number": "470-885-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL AND WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2023-09-06",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "FRAGOSO",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "470-885-8080"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@mygracemedical.com",
            "affiliation": "N",
            "endpointDescription": "Practice Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3772 Satellite Blvd Ste 204",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300965681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ivelisse Gotay, SLP
• Mark A Gottlieb, O.D.
• Ramani Gowducheruvu, DDS
• Eva Florence Goyette, D.O.
• Grace Acupuncture & Oriental Medicine
• Robert Davis Grace, D.C.
• Shannon Kathleen Gradert, PHARMD, RPH
• Sean P Grady, DDS
• John C Graeber Jr., CAA
• Elena Granados-Barron

• Family Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Medicine Physician in Georgia

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