Active NPI
Grace Medical Group, LLC
- Family Medicine Physician
- Columbia, SC
National Provider Identifier
1346468204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- GRACE MEDICAL GROUP, LLC
- Practice address
- 3025 Farrow Rd
Columbia, SC 29203 - Phone
- (803) 933-0288
- Fax
- (803) 933-9920
- NPI assigned
- Apr 23, 2007
- Last updated
- Aug 17, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Cynthia Mathews-Betts, MD
- Title
- MD
- Phone
- (803) 933-0288
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary | |
| Internal Medicine Physician | 207R00000X | NU | ||
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | 12184 | SC | |
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | 13924 | SC |
Addresses
Primary practice location
3025 Farrow Rd
Columbia, SC 29203
Mailing address
3025 Farrow Rd
Columbia, SC 29203
Phone (803) 933-0288
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP3812 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D1018654 | Grace Medical Group LLC | Provider-performed microscopy | Oct 27, 2027 |
National Provider Directory
National Provider DirectoryLocations
1333 Taylor St
Ste 3B
Columbia, SC 29201
Phone (803) 933-0288
3025 Farrow Rd
Columbia, SC 29203
Phone (803) 509-5676
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Internal Medicine Physician
- Columbia, SC
- NPI 1588750103
-
- Family Medicine Physician
- Columbia, SC
- NPI 1205806718
-
- Medical Physician Assistant
- Columbia, SC
- NPI 1073535605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1692230400000",
"number": "1346468204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3025 FARROW RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-933-0288",
"fax_number": "803-933-9920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3025 FARROW RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-933-0288",
"fax_number": "803-933-9920"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRACE MEDICAL GROUP, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-23",
"last_updated": "2023-08-17",
"status": "A",
"authorized_official_last_name": "MATHEWS-BETTS",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "803-933-0288",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207QH0002X",
"taxonomy_group": "",
"desc": "Family Medicine, Hospice and Palliative Medicine",
"state": "SC",
"license": "12184",
"primary": false
},
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "SC",
"license": "13924",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP3812",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
- Zendrea E Govan, LISW
- Gregory Grabowski, MD
- Grace Diabetic and Medical Supply Company
- Grace Hope & Love Homecare
- Grace in Healing Home Heath Care Agency LLC
- Grace Speaks Speech Therapy Services of the Carolinas LLC
- Robin Denice Grace, LPC
- Graceful Beginnings Early Intervention Services LLC
- Graceful in Home Care, LLC
- Sarena G Graczyk, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.