Individual provider Active NPI

Joseph Grayson Grau, MD

  • Psychiatry Physician
  • Bowling Green, KY
National Provider Identifier
1508868456
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
3705 Issued in KY
Practice address
350 Park St
Suite 204
Bowling Green, KY 42101-1784
Phone
(270) 843-5103
Fax
(270) 843-5104
NPI assigned
Aug 11, 2005
Last updated
Jan 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 37508 KY
Psychiatry Physician 2084P0800X 3705 KY Primary

Addresses

Primary practice location

350 Park St
Suite 204
Bowling Green, KY 42101-1784

Mailing address

350 Park St
Suite 204
Bowling Green, KY 42101-1784
Phone (270) 843-5103

Other identifiers 1

IdentifierTypeStateIssuer
64052517MedicaidKY

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100920001007 KY Practitioner - Psychiatry 8426173022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Virginia Commonwealth University, School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

350 Park St
Suite 204
Bowling Green, KY 42101-1784
Phone (270) 843-5103

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37508KYMDPsychiatry Physician
3705KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bowling Green-Warren County Community Hospital Corporation Psychiatry CurrentSince Jun 1, 2015 Accepting new patients
Bowling Green-Warren County Community Hospital Corporation CurrentSince Jun 1, 2015 Accepting new patients

Locations

2625 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 745-0942

350 Park St
Ste 204
Bowling Green, KY 42101
Phone (270) 796-6333

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 4

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1508868456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PARK ST",
            "address_2": "SUITE 204",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011784",
            "telephone_number": "270-843-5103",
            "fax_number": "270-843-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PARK ST",
            "address_2": "SUITE 204",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011784",
            "telephone_number": "270-843-5103",
            "fax_number": "270-843-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAU",
        "first_name": "JOSEPH",
        "middle_name": "GRAYSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "37508",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "3705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64052517",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.