Individual provider Active NPI

Brian Grace, MD

  • Anesthesiology Physician
  • Elizabethtown, KY
National Provider Identifier
1730184565
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
38620 Issued in KY
Practice address
639 N Mulberry St
Elizabethtown, KY 42701-1931
Phone
(270) 737-4600
Fax
(270) 737-1722
NPI assigned
Jun 17, 2005
Last updated
Mar 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 38620 KY Primary

Addresses

Primary practice location

639 N Mulberry St
Elizabethtown, KY 42701-1931

Mailing address

639 N Mulberry St
Elizabethtown, KY 42701-1931
Phone (270) 737-4600

Other identifiers 1

IdentifierTypeStateIssuer
6408257MedicaidKY

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
I20040819000664 KY Practitioner - Anesthesiology 6305819061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kentucky College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians

Practice addresses (Care Compare)

913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (270) 706-1212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38620KYMDAnesthesiology Physician
01208NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Anesthesia Services of Kentucky PLLC Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients

Locations

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

Organizations & group practices 1

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 1

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1730184565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 N MULBERRY ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011931",
            "telephone_number": "270-737-4600",
            "fax_number": "270-737-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 N MULBERRY ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011931",
            "telephone_number": "270-737-4600",
            "fax_number": "270-737-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "38620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6408257",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.