Grace Family Medical Clinic, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

117451 Issued in MO

Legal business name

GRACE FAMILY MEDICAL CLINIC, LLC

Practice address

1206 Ward Ave
Caruthersville, MO 63830-2204

Phone

(573) 922-5111

Fax

(573) 922-5126

NPI assigned

Apr 27, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Joseph M Kulpeksa, MD

Title

Owner

Phone

(573) 922-5111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1780119651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 WARD AVE",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638302204",
            "telephone_number": "573-922-5111",
            "fax_number": "573-922-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 WARD AVE",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638302204",
            "telephone_number": "573-922-5111",
            "fax_number": "573-922-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FAMILY MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "KULPEKSA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-922-5111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "117451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Fuller
• Xiomara Garcia
• John D Gardner, D.D.S.
• Heather German
• Glorious in Home and CDS LLC
• Brenda Joyce Gray, LCSW
• Guardian Angels CDS, LLC
• Guardian Angels in Home Services, LLC
• Guardian Angels in Home Services, LLC
• Latoya Shanta Guyton

• Internal Medicine Physician in Caruthersville, MO
• Providers in Caruthersville, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.