NPIMap

Organization Active NPI

Sovereign Medical Consulting LLC

  • Point of Service
  • Greenville, SC
National Provider Identifier
1831696251
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
101491182 Issued in SC
Legal business name
SOVEREIGN MEDICAL CONSULTING LLC
Practice address
15 Villa Rd, Apt #182
Greenville, SC 29615
Phone
(864) 451-4250
NPI assigned
Apr 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Authorized official

Name
Dr. Edward Edmond Grace, PHARM.D.NPI 1295841120
Title
President
Phone
(864) 451-4250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 1835P1200X 308009535 DC
Point of Service 305S00000X 101491182 SC Primary

Addresses

Primary practice location

15 Villa Rd, Apt #182
Greenville, SC 29615

Mailing address

15 Villa Rd, Apt #182
Greenville, SC 29615
Phone (864) 451-4250

Other identifiers 1

IdentifierTypeStateIssuer
101491182OtherSCSC DEPARTMENT OF REVENUE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1831696251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 VILLA RD, APT #182",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29615",
            "telephone_number": "864-451-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 VILLA RD, APT #182",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29615",
            "telephone_number": "864-451-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN MEDICAL CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "EDMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-451-4250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "DC",
            "license": "308009535",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "SC",
            "license": "101491182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC DEPARTMENT OF REVENUE",
            "identifier": "101491182",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.