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Deactivated NPI 1609008069 Deactivated / Inactive NPI Male Practitioner

Dr. Carlos Gregory Grantham , MD

General Practice • Gray, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Carlos Grantham has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 19, 2009
NPI Deactivation Date October 24, 2018
Total Practice Duration ~9 Years of Practice (2009 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Carlos Grantham, MD was a registered General Practice practicing in Gray, GA. Throughout an active medical career spanning 9 years, Dr. Grantham provided care at the practice location at 114 JACKSON AVE until profile deactivation on 2018-10-24.

Historical Medicare Part B clinical services included injection, methylprednisolone acetate, 20 mg, established patient outpatient office visit, injection beneath the skin or into muscle for therapy, diagnosis, or prevention. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

114 Jackson Ave
Post Office Box 352

Gray, GA 310325402

Telephone 4789869355
Fax 4789864325

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Gray, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.9 Yrs
Regional Practice Density
1 Specialists

Practicing in Gray, GA (369 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
J1020 Injection, methylprednisolone acetate, 20 mg
130 22 $40.00 $4.93
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
87 66 $119.79 $39.06
99213 Established patient office or other outpatient visit, typically 15 minutes
86 61 $200.28 $66.03
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention
75 45 $44.00 $22.42
36415 Insertion of needle into vein for collection of blood sample
39 35 $45.00 $2.94
J0696 Injection, ceftriaxone sodium, per 250 mg
27 19 $30.00 $0.67
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
13 13 $200.00 $103.96
J1040 Injection, methylprednisolone acetate, 80 mg
12 11 $100.00 $10.23

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License GA 010170

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 24, 2018

Record deactivated on October 24, 2018

NPI Profile Active December 13, 2013

NPI status registered as active in NPPES database

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Updated Practice Location December 13, 2013

Registered at 114 JACKSON AVE, POST OFFICE BOX 352, GRAY, GA 310325402 (Tel: 4789869355)

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Updated Business Mailing Address December 13, 2013

Registered at 114 JACKSON AVE, POST OFFICE BOX 352, GRAY, GA 310325402 (Tel: 4789869355)

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Provider Name / Credentials Updated December 13, 2013

Recorded as CARLOS GRANTHAM, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 13, 2013

General Practice (License #010170 in GA)

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Initial NPI Registration & Enumeration August 19, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1609008069
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 19, 2009
Last Update: December 13, 2013
Deactivation Date: October 24, 2018

Mailing Address

114 Jackson Ave, Post Office Box 352

Gray, GA 310325402

Phone: 4789869355

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.