DR. JACK G GRACEY (NPI# 1376590372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376590372 |
| Entity Type | Individual |
| Full Name | DR. JACK G GRACEY |
| Credential | M.D. |
| Practice Address |
802 New Holland Ave Suite 200 Lancaster PA 17602-2163 |
| Practice Telephone | 7173581305 |
| Practice Fax Number | 7172919634 |
| Mailing Telephone | 7173581305 |
| Mailing Fax Number | 7172919634 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2012-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD028611L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 000696452001 | 05 |
| Street Address |
802 NEW HOLLAND AVE SUITE 200 |
| City | LANCASTER |
| State | PA |
| Zip Code | 17602-2163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528068137 | Leo George Dorozynsky | Psychiatry & Neurology | 802 New Holland Ave, Lancaster, PA 17602-2287 | 2005-07-26 |
| 1033741988 | Sheila O. Jourdain | Nurse Practitioner | 802 New Holland Ave, Lancaster, PA 17602-2287 | 2020-02-09 |
| 1538681283 | Lancaster Health Center | Clinic/Center | 802 New Holland Ave, Lancaster, PA 17602-2288 | 2017-07-14 |
| 1609324227 | Adriane Davia Esposito | Counselor | 802 New Holland Ave, Suite 100, Lancaster, PA 17602-2287 | 2016-09-12 |
| 1588076434 | Rise Perry | Nurse Practitioner | 802 New Holland Ave, Suite 200, Lancaster, PA 17602-2287 | 2014-05-27 |
| 1568897114 | Kaitlyn Nicole Henry | Social Worker | 802 New Holland Ave, Suite 100, Lancaster, PA 17602-2287 | 2013-09-13 |
| 1487999660 | Courtney Bates | Nurse Practitioner | 802 New Holland Ave, Suite 200, Lancaster, PA 17602-2287 | 2012-11-29 |
| 1356685374 | Justin Robert Walzl | Nurse Practitioner | 802 New Holland Ave, Suite 200, Lancaster, PA 17602-2287 | 2012-11-15 |
| 1386918779 | Umesh Chander Mishra | Internal Medicine | 802 New Holland Ave, Suite 200, Lancaster, PA 17602-2287 | 2012-03-02 |
| 1841500048 | Melissa A Kretz | Registered Nurse | 802 New Holland Ave, Suite 200, Lancaster, PA 17602-2287 | 2010-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313173 | Taylor Giambrone | Registered Nurse | Lgh Nurse Family Partnership, 555 North Duke Street, Lancaster, PA 17602 | 2020-10-12 |
| 1982268843 | Blanche Nichole Breznak | Pharmacist | 201 East Chestnut St, Lancaster, PA 17602 | 2019-04-25 |
| 1285104851 | Stephanie Benedict | Pharmacist | 1603 Lincoln Highway East, Lancaster, PA 17602 | 2018-11-27 |
| 1043709835 | Deborah J Campos-bard, Lmt | Massage Therapist | 439 N. Duke St. 2nd Fl., 2, Lancaster, PA 17602 | 2018-05-07 |
| 1861989493 | Functional Freedom LLC | Occupational Therapist | 105 Heritage Rd., Lancaster, PA 17602 | 2018-04-19 |
| 1083094577 | Gracie Berry | Counselor | 413 Church St, Lancaster, PA 17602 | 2015-06-01 |
| 1366835597 | Holcomb Associates, Inc. | Community/Behavioral Health | 800 New Holland Avenue, Lancaster, PA 17602 | 2015-03-12 |
| 1205236965 | Maria Taylor | Physician Assistant | 555 N Duke Street, Lghp Hospitalists, Lancaster, PA 17602 | 2014-09-01 |
| 1114355104 | Charles Eugene Stream | Physician Assistant | 133 East Fredeick Street, Lancaster, PA 17602 | 2013-10-29 |
| 1710221668 | Kourtney Randsdorp | Occupational Therapist | 105 Heritage Rd, Lancaster, PA 17602 | 2012-11-15 |
| Find all providers in zip 17602 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558659219 | Physician Specialists of Northern Lancaster County | Internal Medicine | 802 New Holland Avenue, Suite 200, Lancaster, PA 17602-2288 | 2011-07-15 |
| 1336434729 | John Lazarus | Internal Medicine | 2405 N Columbus St Ste 100, Lancaster, OH 43130-8189 | 2011-06-14 |
| 1073780938 | Moneer J Eddin | Internal Medicine | 43723 20th St W Ste 101, Lancaster, CA 93534-4784 | 2008-05-09 |
| 1316089873 | Heart Center of The Antelope Valley Medical Group | Internal Medicine | 43807 10th St West, Suite F, Lancaster, CA 93534 | 2007-02-13 |
| 1922146661 | Antelope Valley Cardiology Associates | Internal Medicine | 43723 20th St. West, Ste 101, Lancaster, CA 93534 | 2007-02-02 |
| 1952460248 | Sanjaya Khanal | Internal Medicine | 43807 N 10th St West, Suite F, Lancaster, CA 93534 | 2006-12-06 |
| 1740380880 | Antony Cyril Ernest | Internal Medicine | 43807 10th St W, Suite A, Lancaster, CA 93534-4805 | 2006-09-25 |
| 1417961996 | Paul D. Ruff | Internal Medicine | 125 N Ewing St, Lancaster, OH 43130-3309 | 2006-07-28 |
| 1104877257 | Paul A Slota | Internal Medicine | 1029 W Meeting St, Lancaster, SC 29720-2205 | 2006-05-13 |
| 1932188729 | Giuseppe Gioia | Internal Medicine | 2135 Noll Dr, Lancaster, PA 17603-7602 | 2006-01-11 |
| Find all providers in LANCASTER | ||||
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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.