Individual provider Active NPI

Kameron Grigsby

  • Occupational Therapist
  • Georgetown, KY
National Provider Identifier
1134091515
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
302523 Issued in KY
Practice address
117 E Jefferson St
Georgetown, KY 40324-1764
Phone
(859) 224-2273
Fax
(859) 224-4675
NPI assigned
Sep 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 302523 KY Primary

Addresses

Primary practice location

117 E Jefferson St
Georgetown, KY 40324-1764

Mailing address

109 Wind Haven Dr Ste 100
Nicholasville, KY 40356-8010
Phone (859) 224-2273

Other practice location 1

1013 Center Dr
Richmond, KY 40475-3841
Phone (859) 224-2273

Other practice location 2

799 E Brannon Rd
Nicholasville, KY 40356-6038
Phone (859) 224-2273

Other practice location 3

3499 Blazer Pkwy Ste 170
Lexington, KY 40509-2823
Phone (859) 224-2273

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260428001902 KY Practitioner - Occupational Therapist in Private Practice 1658848585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1650 Lyndon Farm CT
Suite 300
Louisville, KY 40223-4029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302523KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Pediatric Therapy, LLC Occupational Therapist PastSince Sep 28, 2025 Accepting new patients

Organizations & group practices 2

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": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1134091515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WIND HAVEN DR STE 100",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568010",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E JEFFERSON ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241764",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1013 Center Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404753841",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "799 E Brannon Rd",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403566038",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3499 Blazer Pkwy Ste 170",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092823",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIGSBY",
        "first_name": "KAMERON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "302523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.