Active NPI
Kenneth Fred Grant, MD
- Anatomic Pathology & Clinical Pathology Physician
- Columbia, SC
National Provider Identifier
1114997095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 21834
- Practice address
- 1 Science CT
Suite 200
Columbia, SC 29203-9344 - Phone
- (803) 252-1913
- Fax
- (803) 252-2330
- NPI assigned
- Jan 24, 2006
- Last updated
- Aug 7, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 21834 | SC | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 21834 | SC | Primary |
| Blood Banking & Transfusion Medicine Physician | 207ZB0001X | 21834 | SC | |
| Cytopathology Physician | 207ZC0500X | 21834 | SC |
Addresses
Primary practice location
1 Science CT
Suite 200
Columbia, SC 29203-9344
Mailing address
5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T59228 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21834 | SC | MD | Blood Banking & Transfusion Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1114997095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 SOUTHWYCK BLVD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436141509",
"telephone_number": "800-288-8325",
"fax_number": "419-866-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SCIENCE CT",
"address_2": "SUITE 200",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292039344",
"telephone_number": "803-252-1913",
"fax_number": "803-252-2330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "KENNETH",
"middle_name": "FRED",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "SC",
"license": "21834",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "SC",
"license": "21834",
"primary": true
},
{
"code": "207ZB0001X",
"taxonomy_group": "",
"desc": "Pathology, Blood Banking & Transfusion Medicine",
"state": "SC",
"license": "21834",
"primary": false
},
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "SC",
"license": "21834",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "T59228",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.