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GRACE MEDICAL PRACTICE LTD
NPI 1396070744
Family Medicine in East Point, GA

Active since October 02, 2009CLIA 11D2003401 · Waiver
1136 CLEVELAND AVE STE 309, EAST POINT, GA 30344(404) 763-1240(404) 393-6524 Get Directions Write a Review

NPPES record last updated: October 2, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Grace Medical Practice Ltd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE MEDICAL PRACTICE LTD (NPI 1396070744) is a healthcare organization registered as a family medicine in East Point, Georgia and active in the NPI registry since October 2009. The organization holds a CLIA Waiver certificate valid through February 8, 2028 and lists Fidelia O Osinubi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1396070744
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGRACE MEDICAL PRACTICE LTD
Location Address1136 CLEVELAND AVE STE 309East Point, GA 30344-3618
Mailing AddressPo Box 20156Atlanta, GA 30325-0156 · (404) 861-0291 · Fax (404) 393-6524
Phone(404) 763-1240
Fax(404) 393-6524
Organization SubpartNo
Authorized OfficialFidelia O OsinubiCeo · (404) 861-0291
Enumeration DateOctober 2, 2009
✔ NPI 1396070744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 001305
Definition
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.
1136 CLEVELAND AVE STE 309, East Point, GA 30344
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Other Identifiers 2

Other06/11/1956GA · Birth Date
Medicaid778620923AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2003401

Grace Medical Practice, Ltd · Atlanta, GA
Active · expires Feb 8, 2028
CLIA Number11D2003401
Laboratory TypePhysician Office
Certificate Effective DateFebruary 9, 2026
Certificate Expiration DateFebruary 8, 2028
Laboratory DirectorDr. Fidelia Osinubi
Laboratory Phone(404) 763-1240
Laboratory LocationGrace Medical Practice, Ltd3885 Princeton Lakes Way, Atlanta, GA 30331
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BARBARA L FIELDS, MDPC
Internal Medicine
1136 CLEVELAND AVE STE 309
EAST POINT, GA 30344
Fulton County (404) 763-1240

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grace Medical Practice Ltd's NPI number?

The NPI number for Grace Medical Practice Ltd is 1396070744. It was assigned to this organization in the NPPES registry on October 2, 2009.

Where is Grace Medical Practice Ltd located?

Grace Medical Practice Ltd is located at 1136 Cleveland Ave Ste 309, East Point, GA 30344. The listed phone number is (404) 763-1240.

What is Grace Medical Practice Ltd's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Grace Medical Practice Ltd hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2003401) is associated with this NPI, valid through February 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grace Medical Practice Ltd was last updated on October 2, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.