Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

DIVINEGRACE PRIMARY URGENT CARE IV HYDRATION & WELLNESS CLINIC LLC

Practice address

9420 Annapolis Rd Ste 103
Lanham, MD 20706-3033

Phone

(240) 476-9409

Fax

(240) 436-0043

NPI assigned

Oct 16, 2023

Organization subpart

No

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

Authorized official

Name

Grace ChikezieNPI 1134797228

Title

Owner

Phone

(240) 476-9409

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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.

• Grace Chikezie

  • Family Nurse Practitioner
  • Greenbelt, MD
  • NPI 1134797228
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1780466771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12912 CROSSFIELD DR",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207056334",
            "telephone_number": "240-476-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 ANNAPOLIS RD STE 103",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063033",
            "telephone_number": "240-476-9409",
            "fax_number": "240-436-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINEGRACE PRIMARY URGENT CARE IV HYDRATION & WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "CHIKEZIE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-476-9409"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diversity Behavioral Health Services
• Divine Hands Heathcare Services Inc
• Divine Health Care Services
• Divine Health Care Services, Inc.
• Divinecare Residence Inc
• Divinelink Care Services LLC
• Alexandra Dixon
• Helen P Dixon
• Synthia Feupi Djialac
• Jules Isaac Djomo Djomo

• Family Nurse Practitioner in Lanham, MD
• Providers in Lanham, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.