Individual provider Active NPI

Grady Ross Rowe, PA

  • Medical Physician Assistant
  • Linden, TN
National Provider Identifier
1306506241
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
62 Medical Dr Ste a
Linden, TN 37096-3305
Phone
(315) 892-6009
Fax
(931) 589-2602
NPI assigned
Dec 20, 2021
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

62 Medical Dr Ste a
Linden, TN 37096-3305

Mailing address

1474 Amy Ave
Clarksville, TN 37042-7037
Phone (865) 340-7912

Other practice location 1

1474 Amy Ave
Clarksville, TN 37042-7037
Phone (865) 340-7912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240418000665 TN Practitioner - Physician Assistant 1355780743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alm and Agm LLCGroup PAC ID 6608263090, 8 clinicians

Practice addresses (Care Compare)

62 Medical Dr
Suite a
Linden, TN 37096-3305
Phone (931) 589-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5488TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Walk-in Medical Clinic of Linden PLLC Past 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.

Hospital & facility affiliations 2

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": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1306506241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1474 AMY AVE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427037",
            "telephone_number": "865-340-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MEDICAL DR STE A",
            "city": "LINDEN",
            "state": "TN",
            "postal_code": "370963305",
            "telephone_number": "315-892-6009",
            "fax_number": "931-589-2602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1474 Amy Ave",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370427037",
            "country_code": "US",
            "telephone_number": "865-340-7912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROWE",
        "first_name": "GRADY",
        "middle_name": "ROSS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-20",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linden, TN

Sources for this page

Verify at the official NPI Registry.