Individual provider Active NPI

Karl K. Gruber, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • N Charleston, SC
National Provider Identifier
1619944758
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
17430 Issued in SC
Practice address
9330 Medical Plaza Dr
N Charleston, SC 29406-9104
Phone
(843) 797-4179
Fax
(843) 797-4296
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 17430 SC Primary

Addresses

Primary practice location

9330 Medical Plaza Dr
N Charleston, SC 29406-9104

Mailing address

PO Box 49009
Greenwood, SC 29649-0001
Phone (864) 223-3070

Other identifiers 1

IdentifierTypeStateIssuer
174305MedicaidSC

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190326002092 VI Practitioner - Pathology 9436330545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical University of South Carolina College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4007 Estate Diamond Ruby
St Croix, VI 00820-4435
Phone (340) 778-6377

Hospital & facility affiliations

  • Gov Juan F Luis Hospital & Medical Ctr Hospital, St Croix, VI, CCN 480002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
VI Pathology LLC Anatomic Pathology & Clinical Pathology CurrentSince Aug 13, 2018 Accepting new patients

Locations

4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1619944758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49009",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490001",
            "telephone_number": "864-223-3070",
            "fax_number": "864-223-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 MEDICAL PLAZA DR",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069104",
            "telephone_number": "843-797-4179",
            "fax_number": "843-797-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "KARL",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "17430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174305",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Charleston, SC

Sources for this page

Verify at the official NPI Registry.