Grace Healthcare Services Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

GRACE HEALTHCARE SERVICES INC

Practice address

5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344

Phone

(301) 576-3515

NPI assigned

Jun 19, 2023

Organization subpart

No

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

Authorized official

Name

Siphra Ngum Mukoro, PMHNPNPI 1477289619

Title

NP

Phone

(301) 675-3515

Specialties & licenses 1

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.

• Siphra Ngum Mukoro

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
  • NPI 1477289619
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1902581978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE STE 250",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048344",
            "telephone_number": "301-576-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE STE 250",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048344",
            "telephone_number": "301-576-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "MUKORO",
        "authorized_official_first_name": "SIPHRA",
        "authorized_official_middle_name": "NGUM",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "301-675-3515",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Rae Goss
• Lisa Gottlieb, LICSW
• Cheryl M Gough, R.N.
• Omar Gowayed, M.D.
• Grace by Mercy Health Care Services Inc
• David Mark Grace, DPM
• Paula Grace, LCSW C
• Kevin David Graditor, LCSW-C
• Alice Marie Graham
• David B Graham, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Frederick, MD
• Providers in Frederick, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.