Organization Active NPI

Anmed Health

Doing business as AnMed Primary Care - Lakeside

  • Family Medicine Physician
  • Anderson, SC
National Provider Identifier
1023318383
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ANMED HEALTH
Doing business as
AnMed Primary Care - Lakeside
Practice address
4120 Highway 24
Anderson, SC 29626-5321
Phone
(864) 512-5830
Fax
(864) 224-4999
NPI assigned
Nov 2, 2010
Last updated
May 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen Jan Grisgby
Title
Cfo
Phone
(864) 512-1109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4120 Highway 24
Anderson, SC 29626-5321

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 512-5830

Other identifiers 1

IdentifierTypeStateIssuer
GP5556MedicaidSC

Other names 1

  • AnMed Primary Care - Lakeside Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000302 SC Part B Supplier - Clinic/Group Practice 1951215243 Receives reassigned benefits from 393 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Anderson, SC; Central, SC; Clemson, SC; Liberty, SC; Pelzer, SC; Pendleton, SC; Piedmont, SC; Seneca, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0963043Anmed Primary Care - Lakeside4120 Highway 24, Anderson, SC 29626Provider-performed microscopyJul 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Anmed Health OB-GYN Associates94 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

4120 Highway 24
Anderson, SC 29626
Phone (864) 224-4003

414 N Fant St
Anderson, SC 29621
Phone (203) 247-9535

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1023318383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-512-5830",
            "fax_number": "864-224-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 HIGHWAY 24",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296265321",
            "telephone_number": "864-512-5830",
            "fax_number": "864-224-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANMED HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "GRISGBY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-512-1109"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5556",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AnMed Primary Care - Lakeside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.