NPIMap

Individual provider Active NPI

Leeanne Jones Grumelot, PA

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1215978556
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
855 Issued in SC
Practice address
200 Patewood Dr Ste B480
Greenville, SC 29615-6327
Phone
(864) 454-4570
Fax
(864) 454-4575
NPI assigned
Jun 9, 2006
Last updated
May 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 855 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste B480
Greenville, SC 29615-6327

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

900 W Faris Rd Fl 2
Greenville, SC 29605-4255
Phone (864) 455-5300

Other practice location 2

1 Doctors Dr
Greenville, SC 29605-4266
Phone (864) 572-7001

Other identifiers 2

IdentifierTypeStateIssuer
855OtherSCSC BOARD OF MEDICAL EXAMI
1525PAMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgrumelot31856@direct.ghs.myhfn.org Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090508000222 SC Practitioner - Physician Assistant 6709934359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Carolina School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

175 Patewood Dr
Greenville, SC 29615-3570
Phone (864) 797-1403

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

701 Grove Rd
Greenville, SC 29605-4210

830 S Buncombe Rd
Greer, SC 29650-2400
Phone (864) 455-2455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
855SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 5, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Jun 5, 2023 Accepting new patients
Premier Surgical Services, PA Past Accepting new patients
Prisma Health University Medical Group Past Accepting new patients
Prisma Health-Upstate Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

200 Patewood Dr
Ste B480
Greenville, SC 29615
Phone (864) 454-4200

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

900 W Faris Rd
Fl 2
Greenville, SC 29605
Phone (864) 455-8898

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: leeanne.grumelot@adac.eclinicaldirectplus.com
  • Direct secure messaging: lgrumelot31856@direct.ghs.myhfn.org

Organizations & group practices 6

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

Hospital & facility affiliations 44

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1215978556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B480",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156327",
            "telephone_number": "864-454-4570",
            "fax_number": "864-454-4575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 W Faris Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054255",
            "country_code": "US",
            "telephone_number": "864-455-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054266",
            "country_code": "US",
            "telephone_number": "864-572-7001",
            "fax_number": "864-412-0436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUMELOT",
        "first_name": "LEEANNE",
        "middle_name": "JONES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC BOARD OF MEDICAL EXAMI",
            "identifier": "855",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgrumelot31856@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Provider",
            "address_1": "900 W Faris Rd Fl 2",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.