Individual provider Active NPI

Zachary Thomas Grambos, M.D.

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1225392624
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
LL34622 Issued in SC
Practice address
5 Medical Park
PHR - Dept of Em
Columbia, SC 29203
Phone
(803) 434-3790
Fax
(803) 434-3946
NPI assigned
Jun 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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 LL34622 SC Primary

Addresses

Primary practice location

5 Medical Park
PHR - Dept of Em
Columbia, SC 29203

Mailing address

5 Medical Park
PHR - Dept of Em
Columbia, SC 29203
Phone (803) 434-3790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TN2 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
I20150126001188 SC Practitioner - Emergency Medicine 3577887496 Reassigns benefits to 1 organization
I20160901001659 TN Practitioner - Emergency Medicine 3577887496 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL34622SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Midlands Current Accepting new patients
Middle Tennessee Emergency Physicians PC Emergency Medicine CurrentSince Jul 15, 2016 Accepting new patients
Prisma Health-Midlands Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

1330 Taylor St
Ste 100
Columbia, SC 29201
Phone (803) 434-6410

400 Palmetto Health Pkwy
Columbia, SC 29212
Phone (803) 296-5579

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

Organizations & group practices 3

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1225392624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK",
            "address_2": "PHR - DEPT OF EM",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-3790",
            "fax_number": "803-434-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK",
            "address_2": "PHR - DEPT OF EM",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-3790",
            "fax_number": "803-434-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMBOS",
        "first_name": "ZACHARY",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "LL34622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.