Organization Active NPI

Kaiberg LLC

  • Surgery Physician
  • Central, SC
National Provider Identifier
1114896586
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
KAIBERG LLC
Practice address
209 Joseph St
Central, SC 29630-9276
Phone
(443) 812-5989
NPI assigned
Nov 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
Eric Hans Gruenberger, MDNPI 1174975734
Title
Direct Owner
Phone
(443) 812-5989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

209 Joseph St
Central, SC 29630-9276

Mailing address

209 Joseph St
Central, SC 29630-9276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20251110000501 SC Part B Supplier - Clinic/Group Practice 5294225041 Receives reassigned benefits from 1 practitioner
Practice locations: Central, SC
O20260512003704 GA Part B Supplier - Clinic/Group Practice 5294225041 Receives reassigned benefits from 1 practitioner
Practice locations: Macon, GA

National Provider Directory

National Provider Directory
Tax ID family
Kaiberg LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1114896586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 JOSEPH ST",
            "city": "CENTRAL",
            "state": "SC",
            "postal_code": "296309276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 JOSEPH ST",
            "city": "CENTRAL",
            "state": "SC",
            "postal_code": "296309276",
            "telephone_number": "443-812-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIBERG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "GRUENBERGER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "HANS",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "443-812-5989",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.