Charles J Gruich, M.D.

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

08349 Issued in MS

Practice address

2356 Pass Rd
Suite 100
Biloxi, MS 39531-2236

Phone

(228) 388-7080

Fax

(228) 388-7493

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1457436347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 PASS RD",
            "address_2": "SUITE 100",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312236",
            "telephone_number": "228-388-7080",
            "fax_number": "228-388-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 PASS RD",
            "address_2": "SUITE 100",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312236",
            "telephone_number": "228-388-7080",
            "fax_number": "228-388-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUICH",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "MS",
            "license": "08349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC.#",
            "identifier": "08349",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tenierdra Griffin, LMSW
• Cameron S Griffith, MD
• Mark Griffith, PA
• Gruich Pharmacy Shoppe
• Gruich Pharmacy Shoppe
• Frank George Gruich Jr.
• Mitchell J Gruich, M.D., F.A.A.P.
• Aja Danielle Guice, CTRS
• Patrick Lewis Guin, DO
• Gulf Coast Abc Pediatrics, Inc.

• Physical Disabilities Residential Treatment Facility in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Physical Disabilities Residential Treatment Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.