Active NPI
Grayson Keith Carter, DO
- Emergency Medicine Physician
- Port St Lucie, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DO229960
- Practice address
- 1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521 - Phone
- (772) 932-4163
- NPI assigned
- Mar 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | DO229960 | OR | Primary |
| Emergency Medicine Physician | 207P00000X | 111040 | GA |
Addresses
Primary practice location
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Mailing address
1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Other practice location 1
1515 Village Dr
Cottage Grove, OR 97424-9700
Phone (541) 767-5222
Other practice location 2
3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 651-6105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Edward Via Col of Osteo Medicine-Carolinas Campus, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1115 SE 164TH Ave Dept
Suite 358
Vancouver, WA 98683-8004
1515 Village Dr
Cottage Grove, OR 97424-9767
Hospital & facility affiliations
- McLeod Loris Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Cottage Grove, OR
- NPI 1902892391
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Loris, SC
- NPI 1306123344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1497457097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 SE TIFFANY AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 SE TIFFANY AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527521",
"telephone_number": "772-932-4163"
}
],
"practiceLocations": [
{
"address_1": "1515 Village Dr",
"address_purpose": "LOCATION",
"city": "Cottage Grove",
"state": "OR",
"postal_code": "974249700",
"country_code": "US",
"telephone_number": "541-767-5222",
"fax_number": "541-767-5230",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3651 Wheeler Rd",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309096521",
"country_code": "US",
"telephone_number": "706-651-6105",
"fax_number": "706-868-1041",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARTER",
"first_name": "GRAYSON",
"middle_name": "KEITH",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-20",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OR",
"license": "DO229960",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "111040",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- 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.