NPIMap

Individual provider Active NPI

David Wayne Grantham, MD

  • Surgery Physician
  • Pinehurst, NC
National Provider Identifier
1689871683
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2007-01020 Issued in NC
Practice address
5 First Village Drive
Pinehurst, NC 28374-2000
Phone
(910) 295-6831
Fax
(910) 295-0244
NPI assigned
Jul 2, 2007
Last updated
Sep 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2007-01020 NC Primary

Addresses

Primary practice location

5 First Village Drive
Pinehurst, NC 28374-2000

Mailing address

5 Firstvillage Drive
PO Box 2000
Pinehurst, NC 28374
Phone (910) 295-6831

Other identifiers 8

IdentifierTypeStateIssuer
7263977OtherAETNA
199308OtherMEDCOST
3810009398MedicaidWV
810125OtherPARTNERS
1689871683MedicaidVA
145NYOtherBCBS
5907193MedicaidNC
Q20007MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081101000142 NC Practitioner - General Surgery 6406940618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinehurst Surgical Clinic PAGroup PAC ID 4587561394, 92 clinicians
MCPC-9 LLCGroup PAC ID 1658526710, 57 clinicians

Practice addresses (Care Compare)

5 1St Village Dr
Pinehurst, NC 28374-9495
Phone (910) 295-6831

809 S Long Dr
Rockingham, NC 28379-4377
Phone (910) 417-4096

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)27
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux20
Melanoma (skin cancer) excision14
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-9, LLC CurrentSince Mar 1, 2014 Accepting new patients
Pinehurst Surgical Clinic PA Surgery CurrentSince Jul 15, 2008 Accepting new patients
Hamlet Hma PPM LLC Surgery Past Accepting new patients
Pinehurst Surgical Clinic PA Surgery PastSince Sep 20, 2022 Accepting new patients

Locations

5 First Village Dr
Pinehurst, NC 28374
Phone (910) 235-2713

809 S Long Dr
Ste K
Rockingham, NC 28379
Phone (910) 417-4090

Interoperability endpoints

  • Direct secure messaging: davidgrantham@fhss.allscriptsdirect.net
  • Direct secure messaging: davidgrantham@psc.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1689871683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FIRSTVILLAGE DRIVE",
            "address_2": "PO BOX 2000",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIRST VILLAGE DRIVE",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283742000",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2007-01020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7263977",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "199308",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009398",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "810125",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689871683",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "145NY",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907193",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q20007",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.