Individual provider Active NPI

Daniel L Gripshover, CP

  • Clinical Neuropsychologist
  • Crestview Hills, KY
National Provider Identifier
1235111634
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1153 Issued in KY
Practice address
503 Centre View Blvd
Crestview Hills, KY 41017-3444
Phone
(859) 426-7800
NPI assigned
Nov 19, 2005
Last updated
May 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1153 KY Primary

Addresses

Primary practice location

503 Centre View Blvd
Crestview Hills, KY 41017-3444

Mailing address

PO Box 17277
Covington, KY 41017-0277
Phone (859) 426-7800

Other identifiers 6

IdentifierTypeStateIssuer
294319000OtherKYMAGELLAN
89000640MedicaidKY
CK6701OtherKYRAILROAD MEDICARE
680015873OtherKYMEDICARE RAILROAD
000000249594OtherKYANTHEM
1199659OtherKYCHA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111209000601 KY Practitioner - Clinical Psychologist 0547435166

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1153KYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
MCB Behavioral Health, P.L.L.C. PastSince May 10, 2001 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1235111634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17277",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410170277",
            "telephone_number": "859-426-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CENTRE VIEW BLVD",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173444",
            "telephone_number": "859-426-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIPSHOVER",
        "first_name": "DANIEL",
        "middle_name": "L",
        "credential": "CP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "1153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "294319000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89000640",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK6701",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "680015873",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000249594",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "1199659",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.