Brennon Chantz Gould, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TC004 Issued in KY

Practice address

175 Hospital Dr
Winchester, KY 40391-9591

Phone

(859) 737-8444

NPI assigned

May 19, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Clark Emergency PhysiciansGroup PAC ID 2961770268, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Lexington Hospital, Lexington, KY, CCN 180103

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Clark Emergency Physicians

  • Emergency Medicine Physician
  • Winchester, KY
  • NPI 1346781499
  Medicare reassignment Care Compare group

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

• Baptist Healthcare System, Inc

  dba Baptist Health Lexington

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1538244918
  Care Compare affiliation

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694822400000",
    "number": "1376234237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 HOSPITAL DR",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403919591",
            "telephone_number": "859-737-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "BRENNON",
        "middle_name": "CHANTZ",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-09-16",
        "certification_date": "2023-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakan Giles, CF-SLP
• Rachel Gilliam, APRN
• Tracy Alexandria Goff, PHARMD
• Haley Goldy
• Clifford Kirby Goodwine, DMD
• Heather Allison Goumas, PT
• Jessica Ann Gousha, LMT
• Gregory F Grau, MD
• Anita A Gray, DDS
• Elizabeth Ann Griffith, M.D.

• Physician Assistant in Winchester, KY
• Providers in Winchester, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.