John W Grace MD PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME85580 Issued in FL

Legal business name

JOHN W GRACE MD PA

Practice address

6226 W Corporate Oaks Dr
Crystal River, FL 34429-8723

Phone

(352) 795-2246

NPI assigned

Sep 29, 2007

Last updated

Sep 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Willard Grace III, M.D.NPI 1497725006

Title

President

Phone

(352) 795-2246

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 5

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.

• John Willard Grace III, M.D.

  • Psychiatry Physician
  • Crystal River, FL
  • NPI 1497725006
  Medicare reassignment NPD Authorized official
• Karen M Champagne-Lister, LSW

  • Clinical Social Worker
  • Crystal River, FL
  • NPI 1114069598
  Medicare reassignment NPD
• Hunter Cooper, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Durham, NC
  • NPI 1093234213

  FL

  Medicare reassignment
• Callie Jo Phillips Eubanks

  • Physician Assistant
  • Ocala, FL
  • NPI 1811547326
  NPD (past)
• Monica Maria Gonzalez, APN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • The Villages, FL
  • NPI 1407078686
  NPD (past)

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

{
    "created_epoch": "1191024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1891982294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6226 W CORPORATE OAKS DR",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344298723",
            "telephone_number": "352-795-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 W CORPORATE OAKS DR",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344298723",
            "telephone_number": "352-795-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W GRACE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-29",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-795-2246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME85580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan's Optical Shop of Crystal River
• Jandk Lastinger Inc.
• Kayla Nicole Jent, PA-C
• Jill Counseling
• John D. Hosner, D.D.S., P.a.
• Johnnie R Degraw Inc
• Renee Johnson, ARNP
• Susan Johnston, PHYSICAL THERAPIST
• Andrew J Jones, D.C.
• Jodi M Jordan, LCSW

• Psychiatry Physician in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.