Organization Active NPI

Grace Pediatrics and Wellness, LLC

  • Family Medicine Physician
  • Blairsville, GA
National Provider Identifier
1811734676
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRACE PEDIATRICS AND WELLNESS, LLC
Practice address
63 Plott St Ste a
Blairsville, GA 30512-3666
Phone
(706) 745-2968
NPI assigned
Jul 10, 2024
Last updated
Dec 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Authorized official

Name
Mrs. Holly Mejia
Title
Office Manager
Phone
(706) 745-2968

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

63 Plott St Ste a
Blairsville, GA 30512-3666

Mailing address

63 Plott St Ste a
Blairsville, GA 30512-3666
Phone (706) 745-2968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250108001012 GA Part B Supplier - Clinic/Group Practice 4789112533 Receives reassigned benefits from 3 practitioners
Practice locations: Blairesville, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2310997Grace Pediatrics and Wellness63 Plott Street, Suite a, Blairsville, GA 30512Certificate of waiverSep 15, 2026

National Provider Directory

National Provider Directory

Locations

63 Plott St
Ste A
Blairsville, GA 30512
Phone (706) 745-2968

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": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1811734676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 PLOTT ST STE A",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123666",
            "telephone_number": "706-745-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 PLOTT ST STE A",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123666",
            "telephone_number": "706-745-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE PEDIATRICS AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A",
        "authorized_official_last_name": "MEJIA",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-745-2968",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.