Grace Pediatric Therapy Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

GRACE PEDIATRIC THERAPY SERVICES LLC

Practice address

400 Becker Dr Ste B
Roanoke Rapids, NC 27870-3165

Phone

(252) 578-1069

NPI assigned

Aug 19, 2025

Organization subpart

No

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

Authorized official

Name

Timothy AllenNPI 1598911539

Title

Owner

Phone

(252) 578-1069

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

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

• Timothy Scott Allen, MPT

  • Physical Therapist
  • Roanoke Rapids, NC
  • NPI 1598911539
  Medicare reassignment NPD Authorized official
• Christine E Smith, OTR/L

  • Occupational Therapist
  • Roanoke Rapids, NC
  • NPI 1669329041
  Medicare reassignment
• Larissa Conner Moseley, M.S., BCBA

  • Behavior Analyst
  • Rocky Mount, NC
  • NPI 1235977943
  NPD

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1932086022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BECKER DR STE B",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703165",
            "telephone_number": "252-578-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BECKER DR STE B",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703165",
            "telephone_number": "252-578-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE PEDIATRIC THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-578-1069"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shaquana Byrd Graham, MSW. LCSWA
• Xavier Malique Gray
• Kristen Green, MS CCC-SLP
• Martha L Green
• Trisha Gund

• Behavior Analyst in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.