Individual provider Active NPI

Phillip Thomas Grisdela Jr., MD

  • Orthopaedic Trauma Physician
  • Camp Lejeune, NC
National Provider Identifier
1326508805
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
2025-02933 Issued in NC
Practice address
100 Brewster Blvd
Camp Lejeune, NC 28547-2575
Phone
(910) 450-4357
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A194489 CA
Orthopaedic Trauma Physician 207XX0801X 2025-02933 NC Primary
Orthopaedic Trauma Physician 207XX0801X A194489 CA

Addresses

Primary practice location

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Mailing address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 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
I20240625002419 CA Practitioner - Orthopedic Surgery 3375873045 Reassigns benefits to 1 organization
I20260220002135 NC Practitioner - Orthopedic Surgery 3375873045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

2325 Stantonsburg Rd
Greenville, NC 27834-7534
Phone (919) 731-4048

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A194489CAMDOrthopaedic Surgery Physician
2025-02933NCMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Orthopaedic Surgery CurrentSince Jul 1, 2024 Accepting new patients
Vidant Medical Group LLC CurrentSince Jan 18, 2026 Accepting new patients
Usc Care Medical Group, Inc Orthopaedic Surgery CurrentSince Jul 1, 2024 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Ste 2000
Los Angeles, CA 90033
Phone (323) 442-5830

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

2325 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 752-5156

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Interoperability endpoints

  • Direct secure messaging: pgrisdela251904@direct.bilh.masshiway.net

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.

Hospital & facility affiliations 2

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1326508805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "910-450-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-847-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISDELA",
        "first_name": "PHILLIP",
        "middle_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A194489",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NC",
            "license": "2025-02933",
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "CA",
            "license": "A194489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

Verify at the official NPI Registry.