NPIMap

Individual provider Active NPI

Phillip W Bale, MD

  • Family Medicine Physician
  • Glasgow, KY
National Provider Identifier
1376533992
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20062 Issued in KY
Practice address
1330 N Race St
Glasgow, KY 42141-3465
Phone
(270) 629-5111
Fax
(270) 783-3760
NPI assigned
Oct 25, 2005
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20062 KY Primary

Addresses

Primary practice location

1330 N Race St
Glasgow, KY 42141-3465

Mailing address

201 Park St
Bowling Green, KY 42101-1759
Phone (270) 780-2497

Other identifiers 1

IdentifierTypeStateIssuer
64200629MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070919000378 KY Practitioner - Family Practice 2365536562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

1330 N Race St
Glasgow, KY 42141-3465
Phone (270) 629-5111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Mar 1, 2014 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Mar 1, 2014 Accepting new patients
Kentucky Center for the Prevention of Heart Attack Stoke and Diabetes Family Medicine PastSince Sep 1, 2007 Accepting new patients

Locations

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

1330 N Race St
Glasgow, KY 42141
Phone (270) 629-2780

1330 N Race St
Ste 2
Glasgow, KY 42141
Phone (270) 651-6791

Interoperability endpoints

  • Direct secure messaging: phillipbale@ggc.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Glasgow State Nursing FacilityGlasgow, KY, CCN 185363 Skilled nursing facility Corporate Officer
Adp of the SNF		 Aug 1, 1979
Aug 1, 1979

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 5

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1376533992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-780-2497",
            "fax_number": "270-783-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413465",
            "telephone_number": "270-629-5111",
            "fax_number": "270-783-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALE",
        "first_name": "PHILLIP",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "20062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64200629",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.