Individual provider Active NPI

Gracy Billingsley

  • Clinical Social Worker
  • McDonough, GA
National Provider Identifier
1912319112
Registry record updated Jul 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005694 Issued in GA
Practice address
2020 Avalon Pkwy Ste 342
McDonough, GA 30253-3054
Phone
(770) 545-4998
NPI assigned
May 22, 2014
Last updated
Jul 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW005694 GA Primary

Addresses

Primary practice location

2020 Avalon Pkwy Ste 342
McDonough, GA 30253-3054

Mailing address

100 Postmaster Dr Unit 3482
McDonough, GA 30253-2836
Phone (770) 545-4998

Other practice location 1

2606 Mandalay Parkway
McDonough, GA 30253
Phone (770) 545-4998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190904000332 GA Practitioner - Clinical Social Worker 6901135706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563667200000",
    "number": "1912319112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 POSTMASTER DR UNIT 3482",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302532836",
            "telephone_number": "770-545-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 AVALON PKWY STE 342",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533054",
            "telephone_number": "770-545-4998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2606 Mandalay Parkway",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "30253",
            "country_code": "US",
            "telephone_number": "770-545-4998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BILLINGSLEY",
        "first_name": "GRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2019-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.