GRACE KLINIC, LLC (NPI# 1164969168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164969168 |
| Entity Type | Organization |
| Organization Name | GRACE KLINIC, LLC |
| Practice Address |
6516 Falls of Neuse Rd 110 Raleigh NC 27615-6847 |
| Practice Telephone | 9198846191 |
| Mailing Telephone | 9198846191 |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |
| Authorized Official Name | EDDYSON OKHIHAN (CEO) |
| Authorized Official Telephone | 9198846191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6516 FALLS OF NEUSE RD 110 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27615-6847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881112324 | Stephanie Smith | Social Worker | 6516 Falls of Neuse Rd, Raleigh, NC 27615-6847 | 2017-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278535 | Emily Grace Johnson | Behavior Technician | 119 Wind Chime Court, Suite 4, Raleigh, NC 27615 | 2020-09-06 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1972146967 | Atlantic Avenue Pharmaceutical, Inc | Pharmacy | 5621 Atlantic Ave, Suite 103, Raleigh, NC 27615 | 2019-10-22 |
| 1023503950 | Siyara Shannay Dobbs | Social Worker | 7013 Woodbend Dr Apt H, Raleigh, NC 27615 | 2018-06-23 |
| 1194210153 | Brittanie Ja'nell Harris | Dentist | 1911 Falls Valley Dr Ste 107, Raleigh, NC 27615 | 2018-06-22 |
| 1710489448 | Sherise Swensen | Social Worker | 8368 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2018-03-08 |
| 1881100345 | Casey Paul Baine | Counselor | 6330 Falls of Neuse Rd Ste 104, Raleigh, NC 27615 | 2017-12-20 |
| 1588177885 | Michael Lacidonia | Acupuncturist | 6400 Falls of Neuse Rd Ste 200, Raleigh, NC 27615 | 2017-11-08 |
| 1457877631 | Matt Henderson | Behavioral Analyst | 8374 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2017-08-18 |
| 1760907646 | Shakeda Muldrow | Social Worker | 7323 Brookbank Lane, Raleigh, NC 27615 | 2017-08-11 |
| Find all providers in zip 27615 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285195768 | Rebecca Lee Hill | Physician Assistant | 3100 Blue Ridge Rd Ste 103, Raleigh, NC 27612-8002 | 2019-03-27 |
| 1306300520 | Lanlen Luke Venable | Physician Assistant | 4414 Lake Boone Trl Ste 502, Raleigh, NC 27607-7521 | 2019-01-23 |
| 1942723788 | Elizabeth Grace Carmen Lee Macarthur | Physician Assistant | 10211 Alm St Ste 1200, Raleigh, NC 27617-8221 | 2017-07-24 |
| 1982075073 | David Zuckerman | Physician Assistant | 1311 E Millbrook Rd Ofc, Raleigh, NC 27609-5473 | 2015-10-14 |
| 1649570060 | Jeffrey M Rosowski | Physician Assistant | 3320 Executive Dr Ste 222, Raleigh, NC 27609-7445 | 2010-11-02 |
| 1023332020 | Brooke Register Lilley | Physician Assistant | 6500 Creedmoor Rd., Raleigh, NC 27613 | 2010-03-18 |
| 1548582620 | Melanie Fox Langston | Physician Assistant | 7870 Alexander Promenade Pl, Raleigh, NC 27617-7350 | 2010-02-17 |
| 1184863086 | Lisa Marie Hill | Physician Assistant | 2709 Blue Ridge Rd Ste 320, Raleigh, NC 27607-6462 | 2009-02-17 |
| 1538248125 | Harry David Kurtz | Physician Assistant | 4509 Creedmoor Rd Ste 201, Raleigh, NC 27612-3813 | 2006-11-03 |
| 1952495475 | Stephanie E Mason | Physician Assistant | 3480 Wake Forest Rd Ste 500, Raleigh, NC 27609-7376 | 2006-10-02 |
| Find all providers in RALEIGH | ||||
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| 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.