Active NPI
Martin Gravil, PHARM D
- Pharmacist
- Leitchfield, KY
National Provider Identifier
1285761726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 012885
- Practice address
- 311 N Main St
Leitchfield, KY 42754-2230 - Phone
- (270) 259-2474
- NPI assigned
- Feb 28, 2007
- Last updated
- Dec 20, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 012885 | KY | Primary |
Addresses
Primary practice location
311 N Main St
Leitchfield, KY 42754-2230
Mailing address
1239 Woodland Dr
Elizabethtown, KY 42701-2770
Phone (270) 739-0303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 012885 | Other | KY | KY PHARMACIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012885 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
311 N Main St
Leitchfield, KY 42754
Phone (270) 259-2474
Organizations & group practices 3
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.
-
- Community/Retail Pharmacy
- Elizabethtown, KY
- NPI 1316960453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1285761726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1239 WOODLAND DR",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012770",
"telephone_number": "270-739-0303",
"fax_number": "270-234-0101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 N MAIN ST",
"city": "LEITCHFIELD",
"state": "KY",
"postal_code": "427542230",
"telephone_number": "270-259-2474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVIL",
"first_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "012885",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KY PHARMACIST LICENSE",
"identifier": "012885",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leitchfield, KY
- Nathaniel J. Gastaldo, DPM
- Gay Fulkerson,M.D.,P.S.C.
- Angela Mae Gibson, PHARMD
- Scott Anthony Gibson, M.A.
- Robert Carroll Goodman Jr., PHARMD., BCPS
- Grayson County Board of Education
- Grayson County Emergency Medical Services, Inc.
- Grayson County Family Medicine, PLLC
- Grayson County Health Department
- Grayson County Hospital Foundation Inc (Twin Lakes Regional Medical Center Swing)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.