GRACE FAMILY PRACTICE CLINIC, P.C. (NPI# 1083124671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083124671 |
| Entity Type | Organization |
| Organization Name | GRACE FAMILY PRACTICE CLINIC, P.C. |
| Practice Address |
1716 Parr Ave Ste D Dyersburg TN 38024-2074 |
| Practice Telephone | 7312880911 |
| Practice Fax Number | 7312880065 |
| Mailing Telephone | 7312880911 |
| Mailing Fax Number | 7312880065 |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2017-10-09 |
| Authorized Official Name | MONIQUE CASEY-BOLDEN (PRESIDENT) |
| Authorized Official Telephone | 7312880911 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MD25289 | TN | Allopathic & Osteopathic Physicians |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN13637 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | MD35727 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
1716 PARR AVE STE D |
| City | DYERSBURG |
| State | TN |
| Zip Code | 38024-2074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487788501 | Family Care, P.C. | Family Medicine | 1716 Parr Ave Ste D, Dyersburg, TN 38024-2074 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235760273 | Alison Clement | Nurse Practitioner | 750 W Highway 51 Bypass, Dyersburg, TN 38024 | 2020-01-29 |
| 1861030652 | Pagela Jobe | Nurse Practitioner | 750 West Highway 51 Bypass, Dyersburg, TN 38024 | 2019-12-12 |
| 1083184055 | Whitney Young | Nurse Practitioner | 455 East Parkview, Dyersburg, TN 38024 | 2018-12-03 |
| 1518434067 | Myeyedr Optometry of Tennessee, LLC | Optometrist | 400 Us Hwy 51 S, Dyersburg, TN 38024 | 2018-11-01 |
| 1225529142 | Kidney Experts Pllc | Internal Medicine | 1575 Parr Ave # B, Dyersburg, TN 38024 | 2018-05-25 |
| 1407344690 | Darnisha Williams | Pharmacist | 2650 Lake Road, Dyersburg, TN 38024 | 2018-04-24 |
| 1376081547 | Chasidy Branch | Counselor | 640 U.S. Highway 51 Bypass E. Suite M, Dyersburg, TN 38024 | 2017-02-07 |
| 1548671845 | Shree Ramakant Mulay | Internal Medicine | 1575 Parr Ave Ste B, Dyersburg, TN 38024 | 2014-05-08 |
| 1588904965 | Selina Carol Purvis | Physical Therapy Assistant | 1900 Parr Avenue, Dyersburg, TN 38024 | 2013-02-22 |
| 1326396029 | Tennessee Sleep Managment LLC | Clinic/Center | 1190 Hwy 51 By-pass West, Suite C, Dyersburg, TN 38024 | 2012-08-28 |
| Find all providers in zip 38024 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275033888 | Angela Dawn Upchurch | Family Medicine | 1355 Flowering Dogwood Ln, Dyersburg, TN 38024-2893 | 2018-02-20 |
| 1548778632 | Frankie Joe Carroll | Family Medicine | 1954 Saint John Ave Ste 1, Dyersburg, TN 38024-2034 | 2018-01-11 |
| 1487788501 | Family Care, P.C. | Family Medicine | 1716 Parr Ave Ste D, Dyersburg, TN 38024-2074 | 2007-03-14 |
| 1588775894 | Erica D Scheffer | Family Medicine | 1504 Yellow Twig Ln, Dyersburg, TN 38024-2955 | 2006-08-31 |
| 1275558397 | Debra Kay Mckenzie | Family Medicine | 115 Poplar Cir, Dyersburg, TN 38024-6570 | 2006-07-12 |
| 1922006055 | Doreen Eleanor Feldhouse | Family Medicine | 1716 Parr Ave, Suite D, Dyersburg, TN 38024-2073 | 2005-07-12 |
| 1902451446 | Angela Quick | Family Medicine | 1954 Saint John Ave Ste 1, Dyersburg, TN 38024-2034 | 2019-08-01 |
| 1285199802 | Stephanie Ann Coleman | Family Medicine | 1355 Flowering Dogwood Ln, Dyersburg, TN 38024-2893 | 2019-02-07 |
| 1477827418 | Care Rite Pllc | Family Medicine | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2012-03-07 |
| 1922390418 | Hari Krishna Salana | Family Medicine | 1445 Us Highway 51 Byp E, Dyersburg, TN 38024-2127 | 2011-05-03 |
| Find all providers in DYERSBURG | ||||
Please comment or provide details below to improve the information on GRACE FAMILY PRACTICE CLINIC, P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.