Individual provider Active NPI

Susan Grumbach, MSN,APRN, FNP-BC

  • Family Nurse Practitioner
  • Camden, SC
National Provider Identifier
1831465624
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F2185 Issued in SC
Practice address
110 E Dekalb St # C
Camden, SC 29020-4432
Phone
(803) 713-0806
Fax
(803) 713-0526
NPI assigned
Mar 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F2185 SC Primary

Addresses

Primary practice location

110 E Dekalb St # C
Camden, SC 29020-4432

Mailing address

110 E Dekalb St # C
Camden, SC 29020-4432
Phone (803) 713-0806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190409000076 SC Practitioner - Nurse Practitioner 1658612239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2185SCMDMedical Physician Assistant
F2185SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Camden Family Care LLC CurrentSince Apr 1, 2019 Accepting new patients
Alice J. Brooks, MD, PA Past Accepting new patients
Community Medical Clinic of Kershaw County Past Accepting new patients
Providence Orthopaedic Group LLC PastSince Apr 1, 2019 Accepting new patients

Locations

1017 Fair St
Camden, SC 29020
Phone (803) 424-1260

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1831465624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E DEKALB ST # C",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290204432",
            "telephone_number": "803-713-0806",
            "fax_number": "803-713-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E DEKALB ST # C",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290204432",
            "telephone_number": "803-713-0806",
            "fax_number": "803-713-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUMBACH",
        "first_name": "SUSAN",
        "credential": "MSN,APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F2185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, SC

Sources for this page

Verify at the official NPI Registry.