Graceland Family Practice

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GRACELAND FAMILY PRACTICE

Practice address

6470 Tippin Ave
Pensacola, FL 32504-8143

Phone

(850) 741-2878

NPI assigned

Oct 22, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Debra Ann Fickling, APRNNPI 1184196669

Title

Provider

Phone

(850) 741-2878

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra Ann Fickling, FNP-C

  • Family Nurse Practitioner
  • Pensacola, FL
  • NPI 1184196669
  NPD Authorized official

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1881293587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6470 TIPPIN AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048143",
            "telephone_number": "850-741-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6470 TIPPIN AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048143",
            "telephone_number": "850-741-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACELAND FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "FICKLING",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "850-741-2878",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184196669",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Care Medical LLC
• Grace Family Practice
• Grace Medical, Inc.
• Larquita Shree Grace
• Sally Maloney Grace, ARNP
• Morgan Gradia
• Jennifer D Grady, PMHNP
• Philip L. Grady, APRN/CRNA
• Julia Jean Graff, LCSW
• Caitlin E. Gragg, M.S., CCC-SLP

• Primary Care Clinic/Center in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.