Mark Edwin Grenkoski, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

38069 Issued in NC

Practice address

409 Tallulah Rd
Robbinsville, NC 28771-8500

Phone

(828) 479-6434

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Appalachian Mountain Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Asheville, NC
  • NPI 1336528314
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1174567754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 JOHNSTON FARM LN",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882670",
            "telephone_number": "865-804-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 TALLULAH RD",
            "city": "ROBBINSVILLE",
            "state": "NC",
            "postal_code": "287718500",
            "telephone_number": "828-479-6434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7575 E Earll Dr",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852516915",
            "country_code": "US",
            "telephone_number": "480-448-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRENKOSKI",
        "first_name": "MARK",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "34687",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "34687",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "38069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3860884",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3159891",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3860883",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3159896",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00206648",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandy Michelle Gibson, ACNP
• Graham County Schools
• Graham County Urgent Care and Family Practice, PLLC
• Granite Falls LTC, LLC
• Granite Falls LTC, LLC
• Elizabeth Grace Gunter, SLP
• Jacob Hamm
• Joel Harbolt, DPT
• Wayne Kenneth Hoffman, M.D.
• Caitlin Jarrell

• All providers in Robbinsville, NC
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.