Individual provider Active NPI

Grayson Goldman, DO

  • Emergency Medicine Physician
  • Richmond, VA
National Provider Identifier
1174933253
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102205628 Issued in VA
Practice address
5801 Bremo Rd
Richmond, VA 23226-1907
Phone
(804) 285-2011
NPI assigned
Apr 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102205628 VA Primary

Addresses

Primary practice location

5801 Bremo Rd
Richmond, VA 23226-1907

Mailing address

5801 Bremo Rd
Richmond, VA 23226-1907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160510000274 PA Practitioner - Emergency Medicine 2163640442 Reassigns benefits to 3 organizations
I20191029001322 VA Practitioner - Emergency Medicine 2163640442 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102205628VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Miners Medical Center LLC CurrentSince Mar 20, 2016 Accepting new patients
Nason Physician Practices LLC Emergency Medicine CurrentSince Jan 1, 2018 Accepting new patients
Nason Physician Practices LLC Emergency Medicine CurrentSince Jan 1, 2018 Accepting new patients
DLP Conemaugh Miners Medical Center LLC Emergency Medicine CurrentSince Mar 20, 2016 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince May 1, 2022 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Jan 7, 2018 Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince May 1, 2022 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Jan 7, 2018 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1086 Franklin St
#M7
Johnstown, PA 15905
Phone (615) 920-7334

105 Nason Dr
Roaring Spring, PA 16673
Phone (814) 224-2141

104 Hillcrest Dr
Roaring Spring, PA 16673
Phone (814) 224-5455

601 Watkins Centre Pkwy
Midlothian, VA 23114
Phone (804) 594-2100

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1174933253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-285-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "GRAYSON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102205628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.