Active NPI
Owen Charles Grush, M.D.
- Specialist
- Charleston, SC
National Provider Identifier
1457375149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 7146
- Practice address
- 1064 Gardner Rd
Suite 101
Charleston, SC 29407-5768 - Phone
- (843) 766-2983
- Fax
- (843) 571-0601
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 7146 | SC | Primary |
Addresses
Primary practice location
1064 Gardner Rd
Suite 101
Charleston, SC 29407-5768
Mailing address
1064 Gardner Rd
Suite 101
Charleston, SC 29407-5768
Phone (843) 766-2983
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7146 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457375149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1064 GARDNER RD",
"address_2": "SUITE 101",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294075768",
"telephone_number": "843-766-2983",
"fax_number": "843-571-0601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1064 GARDNER RD",
"address_2": "SUITE 101",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294075768",
"telephone_number": "843-766-2983",
"fax_number": "843-571-0601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUSH",
"first_name": "OWEN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "SC",
"license": "7146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.