Grace Internal Medicine, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GRACE INTERNAL MEDICINE, LLC

Practice address

102 Medical Center Dr Ste F
Prattville, AL 36066-7286

Phone

(334) 568-2335

Fax

(334) 380-3567

NPI assigned

Nov 30, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Vanosia Shablee Faison, MDNPI 1023199817

Title

Ceo

Phone

(334) 568-2335

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Vanosia S. Faison, MD

  • Internal Medicine Physician
  • Prattville, AL
  • NPI 1023199817
  Medicare reassignment Care Compare group NPD Authorized official
• Tameka Lene' Myles, FNP-C

  • Family Nurse Practitioner
  • Montgomery, AL
  • NPI 1861958241
  Medicare reassignment Care Compare group NPD
• Lashena Michele Hampton, CRNP

  • Gerontology Nurse Practitioner
  • Montgomery, AL
  • NPI 1871384560
  Medicare reassignment NPD

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1740990886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MEDICAL CENTER DR STE F",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667286",
            "telephone_number": "334-568-2335",
            "fax_number": "334-568-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MEDICAL CENTER DR STE F",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667286",
            "telephone_number": "334-568-2335",
            "fax_number": "334-380-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-30",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "FAISON",
        "authorized_official_first_name": "VANOSIA",
        "authorized_official_middle_name": "SHABLEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-568-2335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drvanosia@graceinternalmed.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "102 Medical Center Dr Ste D",
            "city": "Prattville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "360667286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Glynwood Park Dental Care
• Samantha Jean Gonzalez, M.S., CCC-SLP
• Jaylen T'Keyah Gorden
• Andrea Marjean Gordon, LMT
• Shalini Goswami, M.D.
• Haleigh Gray
• Edwin Price Grice III, PT, ATC
• Destiny Griffin
• Janyth Suzanne Grimes, LPC
• Jennifer Maguire Groff, FNP

• Primary Care Clinic/Center in Prattville, AL
• Providers in Prattville, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.