Active NPI
Edward Edmond Grace, PHARM.D.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Greenville, SC
National Provider Identifier
1295841120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 13491
- Practice address
- 15 Villa Rd, Apt #182
Greenville, SC 29615 - Phone
- (864) 451-4250
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | PS40135 | FL | |
| Pharmacotherapy Pharmacist | 1835P1200X | 1391 | SC | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 13491 | SC | Primary |
Addresses
Primary practice location
15 Villa Rd, Apt #182
Greenville, SC 29615
Mailing address
15 Villa Rd, Apt #182 Apartment 517
Saint Petersburg, SC 29615
Phone (864) 451-4250
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS40135 | Other | FL | BOARD OF PHARMACY |
| 13491 | Other | SC | SC BOARD OF PHARMACY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13491 | SC | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| PS40135 | FL | MD | Pharmacotherapy Pharmacist |
| 1391 | SC | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sovereign Medical Consulting LLC | Pharmacotherapy | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519862400000",
"number": "1295841120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 VILLA RD, APT #182 APARTMENT 517",
"city": "SAINT PETERSBURG",
"state": "SC",
"postal_code": "29615",
"telephone_number": "864-451-4250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 VILLA RD, APT #182",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "29615",
"telephone_number": "864-451-4250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "EDWARD",
"middle_name": "EDMOND",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2018-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "FL",
"license": "PS40135",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "SC",
"license": "1391",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "SC",
"license": "13491",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "PS40135",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SC BOARD OF PHARMACY",
"identifier": "13491",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.