Invictus Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

INVICTUS CLINIC

Practice address

1545 Powers Ferry Rd SE Ste 120
Marietta, GA 30067-9401

Phone

(770) 580-0979

Fax

(678) 383-6735

NPI assigned

May 13, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Brandon Cy Grinage, MDNPI 1033372578

Title

Medical Director

Phone

(770) 580-0979

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Locations

Practitioners 2

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

• Brandon Cy Grinage, M.D.

  • Anesthesiology Physician
  • Marietta, GA
  • NPI 1033372578
  Medicare reassignment Authorized official
• Wesley Eric Karcher, CRNA

  • Certified Registered Nurse Anesthetist
  • Marietta, GA
  • NPI 1053594671
  Medicare reassignment

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725753600000",
    "number": "1972125847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 POWERS FERRY RD SE STE 120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300679401",
            "telephone_number": "770-580-0979",
            "fax_number": "678-383-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 POWERS FERRY RD SE STE 120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300679401",
            "telephone_number": "770-580-0979",
            "fax_number": "678-383-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INVICTUS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-13",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A",
        "authorized_official_last_name": "GRINAGE",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "CY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-580-0979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@theinvictusclinic.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1545 Powers Ferry Rd SE Ste 120",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300679401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinic/Center in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.