Provider Demographics
NPI:1811090566
Name:GROCE, JAMES GRAY (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GRAY
Last Name:GROCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 RALPH DRIVE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4036
Mailing Address - Country:US
Mailing Address - Phone:919-469-1597
Mailing Address - Fax:
Practice Address - Street 1:521 NORTH BRIGHT LEAF BLVD
Practice Address - Street 2:JOHNSTON COUNTY MENTAL HEALTH CENTER
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-0411
Practice Address - Country:US
Practice Address - Phone:919-989-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC173632084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901390Medicaid
1082JOtherBCBS
D26815Medicare UPIN
NC5901390Medicaid