| Grace Primary Care Clinic | |
|
126 Lavender St Spring City TN 37381-5102 | |
| (423) 365-0450 | |
| (888) 355-6415 |
| Full Name | Grace Primary Care Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 126 Lavender St, Spring City, Tennessee |
| Authorized Official Name and Position | Pushkas Gopalan (PRESIDENT) |
| Authorized Official Contact | 4234397280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Primary Care Clinic Po Box 506 Spring City TN 37381-0506 Ph: (423) 365-0450 | Grace Primary Care Clinic 126 Lavender St Spring City TN 37381-5102 Ph: (423) 365-0450 |
| NPI Number | 1598552465 |
|---|---|
| Provider Enumeration Date | 04/23/2025 |
| Last Update Date | 09/08/2025 |
| Certification Date | 09/08/2025 |
| Medicare PECOS PAC ID | 7810491016 |
|---|---|
| Medicare Enrollment ID | O20251105000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598552465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (NU) | Secondary |
| 207R00000X | Internal Medicine | (NU) | Secondary |
| Provider Name | Pushkas Gopalan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376700930 PECOS PAC ID: 3274679949 Enrollment ID: I20091009000427 |
| Provider Name | Beth a Casady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720096159 PECOS PAC ID: 9335333426 Enrollment ID: I20101103000009 |
| Provider Name | Jimmy Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225679376 PECOS PAC ID: 6204246176 Enrollment ID: I20201104000645 |
| Provider Name | Manju Pushkas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528629920 PECOS PAC ID: 5597133967 Enrollment ID: I20221128000180 |
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