GRACE PEDIATRIC CLINIC, P.A. (NPI# 1447307384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447307384 |
| Entity Type | Organization |
| Organization Name | GRACE PEDIATRIC CLINIC, P.A. |
| Practice Address |
2401 Tuckaseegee Rd Charlotte NC 28208-4058 |
| Practice Telephone | 7044093000 |
| Practice Fax Number | 7044092382 |
| Mailing Telephone | 7044093000 |
| Mailing Fax Number | 7044092382 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JULIUS TOKUNBOH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7094093000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 9800405 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 891359N | 05 |
| Street Address |
2401 TUCKASEEGEE RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28208-4058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841256567 | Grace Medical Clinics, Pa | Clinic/Center | 2401 Tuckaseegee Rd, Charlotte, NC 28208-4058 | 2006-04-21 |
| 1508254723 | Erika Mccachern | Nurse Practitioner | 2401 Tuckaseegee Rd, Charlotte, NC 28208-4058 | 2014-12-23 |
| 1891843967 | Pinnacle Medical Clinic, P.a. | Internal Medicine | 2401 Tuckaseegee Rd, Charlotte, NC 28208-4058 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1750929659 | Tru Pearl Solution Services Pllc | Community/Behavioral Health | 2128 Remount Road Suite B, Charlotte, NC 28208 | 2019-12-11 |
| 1245880699 | Camilla A Raley | Technician | 1539 Walton Rd, Charlotte, NC 28208 | 2019-09-18 |
| 1912567041 | Nolan Scott Blake | In Home Supportive Care | 4926 Ridgeley Dr., Suite B, Charlotte, NC 28208 | 2019-06-20 |
| 1699244145 | Catalyst Chiropractic, Pllc | Chiropractor | 2620 Tuckaseegee Rd., Charlotte, NC 28208 | 2018-11-14 |
| 1255854691 | Jessica Lynne Hunter | Social Worker | 2011 Water Walk Lane Apt 209, Charlotte, NC 28208 | 2017-07-18 |
| 1700311420 | Matthew Christian Mundorf | Chiropractor | 2620 Tuckaseegee Rd, Charlotte, NC 28208 | 2017-05-01 |
| 1700235439 | Erin Merchant | Counselor | 2016 Millerton Avenue, #2213, Charlotte, NC 28208 | 2016-06-03 |
| 1528432564 | Monika Sheree Moore | Counselor | 3205 Freedom Dr, Charlotte, NC 28208 | 2015-11-13 |
| 1205224540 | Phadality Home Care | Home Health | 201 S Hoskins Rd., Suite 119, Charlotte, NC 28208 | 2015-01-08 |
| Find all providers in zip 28208 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| 1962042416 | Carolinas Physicians Network Inc | Pediatrics | 1308 Scott Ave, Charlotte, NC 28204-2918 | 2020-01-13 |
| 1083175533 | Denise Makala | Pediatrics | 1000 Blythe Blvd 4th Floor, Meb, Cmc/levine Children's Hospital, Charlotte, NC 28203-5812 | 2019-03-27 |
| 1639565526 | Emily Ogletree | Pediatrics | 8401 Medical Plaza Dr Ste 220, Charlotte, NC 28262-8700 | 2015-04-08 |
| 1811392343 | Adriana Virginia Rosado-jimenez | Pediatrics | 10340 Park Rd Ste B, Charlotte, NC 28210-8401 | 2014-10-27 |
| Find all providers in CHARLOTTE | ||||
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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.