Provider Demographics
NPI:1457420390
Name:WOMAN CARE, LLC
Entity Type:Organization
Organization Name:WOMAN CARE, LLC
Other - Org Name:WOMANCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER STAFF PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-282-6114
Mailing Address - Street 1:301 GORDON GUTMANN BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3766
Mailing Address - Country:US
Mailing Address - Phone:812-282-6114
Mailing Address - Fax:812-650-5315
Practice Address - Street 1:301 GORDON GUTMANN BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3764
Practice Address - Country:US
Practice Address - Phone:812-282-6114
Practice Address - Fax:812-280-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200277430Medicaid
IN192860Medicare ID - Type Unspecified