Individual provider Active NPI

Medhat N. Grace, M.D.

  • Family Medicine Physician
  • Bowling Green, KY
National Provider Identifier
1083608566
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33548 Issued in KY
Practice address
1225 Fairway St
Bowling Green, KY 42103-2477
Phone
(270) 781-3910
Fax
(270) 842-7177
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33548 KY Primary

Addresses

Primary practice location

1225 Fairway St
Bowling Green, KY 42103-2477

Mailing address

201 Park St
Bowling Green, KY 42101-1759
Phone (270) 780-2497

Other identifiers 1

IdentifierTypeStateIssuer
64353485MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20040218000878 KY Practitioner - Family Practice 8022903046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

121 College St
Smiths Grove, KY 42171-8239
Phone (270) 796-5599

Hospital & facility affiliations

  • The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Jul 1, 2015 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Jul 1, 2015 Accepting new patients
Commonwealth Health Corporation, Inc. Past Accepting new patients

Locations

2724 Nashville Rd
Bowling Green, KY 42101
Phone (270) 780-0560

1225 Fairway St
Bowling Green, KY 42103
Phone (270) 781-3910

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

1030 Brookhaven Rd
Franklin, KY 42134
Phone (270) 586-1800

121 College St
Smiths Grove, KY 42171
Phone (270) 563-3000

Interoperability endpoints

  • Direct secure messaging: medhatgrace@ggc.allscriptsdirect.net

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1083608566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-780-2497",
            "fax_number": "270-783-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 FAIRWAY ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421032477",
            "telephone_number": "270-781-3910",
            "fax_number": "270-842-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "MEDHAT",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "33548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64353485",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.