Charles Gordon Grant III, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A165716 Issued in CA

Practice address

9455 Clairemont Mesa Blvd
San Diego, CA 92123-1297

Phone

(858) 266-5000

NPI assigned

Apr 29, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Emergency Medicine

Education

Wright State University Boonshoft School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Group of Columbus LLCGroup PAC ID 2668735515, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Columbus Regional Midtown Hospital, Columbus, GA, CCN 110064

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Emergency Group of Columbus, LLC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1316458227
  Medicare reassignment Care Compare group NPD
• Heritage Physician Services, LLC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1003321969
  Medicare reassignment NPD
• Phoebe Putney Memorial Hospital Inc

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Medicare reassignment NPD
• Phoebe Putney Memorial Hospital Inc

  • Community/Retail Pharmacy
  • Albany, GA
  • NPI 1891315420
  NPD

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

• The Medical Center Inc

  • General Acute Care Hospital
  • Columbus, GA
  • NPI 1255401519
  Care Compare affiliation

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

{
    "created_epoch": "1524960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1710475306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 WESTSIDE DR APT 262",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081232",
            "telephone_number": "253-886-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9455 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231297",
            "telephone_number": "858-266-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "CHARLES",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-29",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A165716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Chiropractic & Sports Rehab, Inc
• Anna Dewey Grant, PT, DPT, OCS
• Avery Grant
• Brandon James Grant, IDC
• Brandon Joseph Grant
• Cheryl Marcia Grant, MFTI
• Colette L. Grant, MD
• Garrett Grant, DC
• Hannah Grant
• Igor Grant, M.D.

• Emergency Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.

Verify at the official NPI Registry.