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GRACELAND FAMILY PRACTICE
NPI 1932708617
Clinic/Center - Primary Care in Pensacola, FL

Active since October 22, 2020CLIA 10D2221994 · Waiver
6470 TIPPIN AVE, PENSACOLA, FL 32504(850) 741-2878 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Graceland Family Practice NPPES

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

GRACELAND FAMILY PRACTICE (NPI 1932708617) is a healthcare organization registered as a primary care in Pensacola, Florida and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through April 25, 2027 and lists Debra Ann Fickling, Provider, as its authorized official.

NPPES Registry Identity

NPI1932708617
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameGRACE FAMILY PRACTICE
Location Address6470 TIPPIN AVEPensacola, FL 32504-8143
Mailing Address6470 Tippin AvePensacola, FL 32504-8143 · (850) 741-2878
Phone(850) 741-2878
Organization SubpartNo
Authorized OfficialDebra Ann FicklingProvider · (850) 741-2878
Enumeration DateOctober 22, 2020
NPPES CertifiedOctober 22, 2020
✔ NPI 1932708617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
6470 TIPPIN AVE, Pensacola, FL 32504
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Other Names 1

Doing Business AsGraceland Family Practice

Other Identifiers 1

Medicaid1184196669FL

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 10D2221994

Grace Family Practice · Pensacola, FL
Active · expires Apr 25, 2027
CLIA Number10D2221994
Laboratory TypePhysician Office
Certificate Effective DateApril 26, 2025
Certificate Expiration DateApril 25, 2027
Laboratory DirectorDebra A. Fickling
Laboratory Phone(850) 741-2878
Laboratory LocationGrace Family Practice6470 Tippin Ave, Pensacola, FL 32504
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

MRS. DEBRA ANN FICKLING FNP-C
Nurse Practitioner (Family)
6470 TIPPIN AVE
PENSACOLA, FL 32504
Escambia County (850) 741-2878
SPECK ENDODONTICS, LLC
Dentist (Endodontics)
6470 TIPPIN AVE
PENSACOLA, FL 32504
Escambia County (850) 969-1060
PETER J. CONGIUNDI, DDS, PA
Dentist (Endodontics)
6470 TIPPIN AVE
PENSACOLA, FL 32504
Escambia County (850) 969-1060
DR. PETER JOSEPH CONGIUNDI DDS
Dentist (Endodontics)
6470 TIPPIN AVE
PENSACOLA, FL 32504
Escambia County (850) 969-1060
DR. STEPHEN HAINES SPECK SR. D.D.S.
Dentist (Endodontics)
6470 TIPPIN AVE
PENSACOLA, FL 32504
Escambia County (850) 969-1060
GRACELAND FAMILY PRACTICE
Clinic/Center (Primary Care)
6470 TIPPIN AVE
PENSACOLA, FL 32504
Escambia County (850) 741-2878

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 Family Practice's NPI number?

The NPI number for Grace Family Practice is 1932708617. It was assigned to this organization in the NPPES registry on October 22, 2020. The provider is doing business as Graceland Family Practice.

Where is Grace Family Practice located?

Grace Family Practice is located at 6470 Tippin Ave, Pensacola, FL 32504. The listed phone number is (850) 741-2878.

What is Grace Family Practice's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Grace Family Practice hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2221994) is associated with this NPI, valid through April 25, 2027. 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 Family Practice was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.