Individual provider Active NPI

Sean Kenneth Grumbach, MD

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1265057178
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
LL84426 Issued in SC
Practice address
Emergency Medicine
14 Medical Park, Ste 350
Columbia, SC 29203
Phone
(803) 434-3790
Fax
(803) 434-6299
NPI assigned
Jun 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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 LL84426 SC Primary

Addresses

Primary practice location

Emergency Medicine
14 Medical Park, Ste 350
Columbia, SC 29203

Mailing address

Emergency Medicine
14 Medical Park, Ste 350
Columbia, SC 29203
Phone (803) 434-3790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230710001956 AL Practitioner - Emergency Medicine 7618336538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of South Carolina School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur Morgan Emergency MedicineGroup PAC ID 0446680862, 24 clinicians

Practice addresses (Care Compare)

1201 7TH St NE
Decatur, AL 35601-3337
Phone (256) 973-2000

Hospital & facility affiliations

  • Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL84426SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Morgan Emergency Medicine Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients

Locations

1874 Beltline Rd SW
Decatur, AL 35601
Phone (256) 301-2211

1201 7th St SE
Decatur, AL 35601
Phone (256) 341-2000

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1265057178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EMERGENCY MEDICINE",
            "address_2": "14 MEDICAL PARK, STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-3790",
            "fax_number": "803-434-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMERGENCY MEDICINE",
            "address_2": "14 MEDICAL PARK, STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-3790",
            "fax_number": "803-434-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUMBACH",
        "first_name": "SEAN",
        "middle_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "LL84426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.