NPIMap

Organization Active NPI

Physician's Pain and Spine Center, LLC

  • Interventional Pain Medicine Physician
  • West Coumbia, SC
National Provider Identifier
1336475573
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PHYSICIAN'S PAIN AND SPINE CENTER, LLC
Practice address
3227-F Sunset Blvd.
Suite 102
West Coumbia, SC 29169-3201
Phone
(803) 724-2336
Fax
(803) 724-2317
NPI assigned
Oct 22, 2009
Last updated
Feb 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Kenneth Russell Grosslight, MD, JDNPI 1194770115
Title
President/Owner
Phone
(803) 724-2336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LP2900X
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X SC Primary

Addresses

Primary practice location

3227-F Sunset Blvd.
Suite 102
West Coumbia, SC 29169-3201

Mailing address

3227-F Sunset Blvd.
Suite 102
West Coumbia, SC 29169-3201
Phone (803) 724-2336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091118000704 SC Part B Supplier - Clinic/Group Practice 8325186950 Receives reassigned benefits from 1 practitioner
Practice locations: West Columbia, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2055925Physician's Pain and Spine Center, LLC3227-F Sunset Blvd, BLDG F, Ste 102, West Columbia, SC 29169Certificate of waiverMar 18, 2027

National Provider Directory

National Provider Directory

Locations

3227 Sunset Blvd
Ste 102
West Columbia, SC 29169
Phone (803) 635-6461

880 W Moultrie St
#200
Winnsboro, SC 29180
Phone (803) 635-6461

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1336475573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3227-F SUNSET BLVD.",
            "address_2": "SUITE 102",
            "city": "WEST COUMBIA",
            "state": "SC",
            "postal_code": "291693201",
            "telephone_number": "803-724-2336",
            "fax_number": "803-724-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227-F SUNSET BLVD.",
            "address_2": "SUITE 102",
            "city": "WEST COUMBIA",
            "state": "SC",
            "postal_code": "291693201",
            "telephone_number": "803-724-2336",
            "fax_number": "803-724-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN'S PAIN AND SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "GROSSLIGHT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "803-724-2336",
        "authorized_official_credential": "MD, JD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.