SOUTHERN GRACE MEDICAL CARE, LLC


Address: 500 Governors Dr Sw, Huntsville, AL 35801-5126
Phone: 2567974118

SOUTHERN GRACE MEDICAL CARE, LLC (NPI# 1649890211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649890211
Entity Type Organization
Organization Name SOUTHERN GRACE MEDICAL CARE, LLC
Practice Address 500 Governors Dr Sw
Huntsville
AL 35801-5126
Mailing Address 1606 Moontown Rd
Brownsboro
AL 35741-9493
Practice Telephone 2567974118
Mailing Telephone 2567763850
Enumeration Date 2020-04-23
Last Update Date 2020-04-23
Authorized Official Name JIMMY GREGORY WINN (FAMILY NURSE PRACTITIONER / OWNER)
Authorized Official Telephone 2567974118
Authorized Official Credential CRNP, NP-C
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AL ALABAMA BOARD OF MEDICAL EXAMINERS 23529 01
AL ALABAMA BOARD OF NURSING, RX NUMBER 8499 01
AL ALABAMA BOARD OF NURSING, RN LICENSE NUMBER 1-159682 01

Office Location

Street Address 500 GOVERNORS DR SW
City HUNTSVILLE
State AL
Zip Code 35801-5126

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013931757 Bonnie J Robertson Nurse Practitioner 500 Governors Dr Sw, Huntsville, AL 35801-5126 2006-07-26
1124648258 Jimmy Gregory Winn Nurse Practitioner 500 Governors Dr Sw, Huntsville, AL 35801-5126 2020-04-18
1710541669 Trinity Medical Center LLC Nurse Practitioner 500 Governors Dr Sw, Huntsville, AL 35801-5126 2019-04-25
1386935799 Kim D Lowery Registered Nurse 500 Governors Dr Sw, Huntsville, AL 35801-5126 2011-04-20
1699065888 The Pinnacle Schools Residential Treatment Facility, Emotionally Disturbed Children 500 Governors Dr Sw, Huntsville, AL 35801-5126 2011-04-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003422742 Elena Mihaela Kruse Nurse Practitioner 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 2020-09-18
1225657661 Ashley Danielle Ford Student in an Organized Health Care Education/Training Program 301 Governors Drive Se, Huntsville, AL 35801 2020-04-15
1407417702 Sasha J White Specialist 410 Governors Dr. Sw, Huntsville, AL 35801 2019-06-26
1003472978 Gina Marie Delgado Nurse Practitioner Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 2019-05-15
1366909863 Lisa Starkey Suggs Nurse Practitioner 3500 Memorial Parkway S.w., Huntsville, AL 35801 2019-02-21
1902373277 Kelly S Fisher LLC Counselor 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 2018-10-25
1073097911 Brittani B Hamrick Psychologist 203 Eastside Sq Ste C9, Huntsville, AL 35801 2018-09-17
1548748312 Jane O. Orton, Licsw, LLC Social Worker 120 Holmes Ave Ne, Huntsville, AL 35801 2018-08-02
1184100661 Regroup Psychological Services Psychologist 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 2018-07-17
1366968398 Bennett Brent Smith Physician Assistant 825 Adams St. Se, Huntsville, AL 35801 2017-08-22
Find all providers in zip 35801

Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194958124 Center for Adult Medicine & Hypertension, PC Clinic/Center 411 Engle Dr Sw, Huntsville, AL 35801-5119 2009-08-25
1811185424 Raynon A. Andrews, Md, PC Clinic/Center 1878 Jeff Road, Suite A, Huntsville, AL 35806 2007-10-09
1124216932 Premier Family Medicine, PC Clinic/Center 4820 University Dr Nw Ste 35, Huntsville, AL 35816-1824 2007-10-05
1255387247 Regional Spine & Wrist Centers,llc Clinic/Center 7540 Memorial Pkwy Sw, Suite W, Huntsville, AL 35802-2265 2006-05-25
1457962508 Daniel R Englert Md LLC Clinic/Center 101 Bob Wallace Ave Sw Ste D, Huntsville, AL 35801-3843 2020-08-12
1063066793 Welbii, LLC Clinic/Center 700 Airport Rd Sw Ste D, Huntsville, AL 35802-4360 2019-07-31
1922667476 Premium Family Care LLC Clinic/Center 333 Whitesport Dr Sw Ste 204, Huntsville, AL 35801-3455 2019-06-09
1932652989 Happi Inc Clinic/Center 4040 Memorial Pkwy Sw, Suite K, Huntsville, AL 35802-4364 2016-07-26
1538530860 Zaheer A. Khan Mdpc Clinic/Center 3007 Memorial Pkwy Sw Ste B, Huntsville, AL 35801-5394 2015-10-13
1487922050 Fox Army Health Clinic Clinic/Center 4100 Goss Rd Sw, Huntsville, AL 35809-0001 2011-12-09
Find all providers in HUNTSVILLE

Competitor

Search similar providers

City HUNTSVILLE
Zip Code 35801

Improve Information

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Dataset Information

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.

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