Individual provider Active NPI

Grace Roberts Holcomb, NP

  • Family Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1962117309
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP260465 Issued in GA
Practice address
1504 N Thornton Ave Ste 103
Dalton, GA 30720-8394
Phone
(770) 962-3642
Fax
(770) 962-3643
NPI assigned
Jan 19, 2023
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN260465 GA
Family Nurse Practitioner 363LF0000X APRN-NP260465 GA Primary

Addresses

Primary practice location

1504 N Thornton Ave Ste 103
Dalton, GA 30720-8394

Mailing address

455 Philip Blvd Ste 140
Lawrenceville, GA 30046-8768
Phone (770) 962-3642

Other practice location 1

100 Liberty Blvd Ste 210
Canton, GA 30114-2852
Phone (770) 962-3642

Other practice location 2

18 Riverbend Dr SW Ste 118
Rome, GA 30161-6019
Phone (770) 962-3642

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250214002598 GA Practitioner - Nurse Practitioner 6002346319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Georgia Pain and Wellness CenterGroup PAC ID 8527200864, 53 clinicians

Practice addresses (Care Compare)

1504 N Thornton Ave
Suite 103
Dalton, GA 30720-8394
Phone (770) 962-3642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP260465GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Pain and Wellness Center CurrentSince Dec 13, 2024 Accepting new patients
Georgia Pain and Wellness Center CurrentSince Dec 13, 2024 Accepting new patients

Locations

100 Liberty Blvd
Ste 210
Canton, GA 30114

1504 N Thornton Ave
Ste 103
Dalton, GA 30720
Phone (706) 278-5275

455 Philip Blvd
Ste 140
Lawrenceville, GA 30046
Phone (787) 618-5889

18 Riverbend Dr SW
Ste 118
Rome, GA 30161
Phone (706) 962-3642

Organizations & group practices 2

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": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1962117309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD STE 140",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468768",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 N THORNTON AVE STE 103",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208394",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Liberty Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301142852",
            "country_code": "US",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-2643",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 Riverbend Dr SW Ste 118",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301616019",
            "country_code": "US",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "GRACE",
        "middle_name": "ROBERTS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN260465",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP260465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.