Individual provider Active NPI

Gary M Harrell, MD

  • Family Medicine Physician
  • Maysville, KY
National Provider Identifier
1780624932
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35065157 Issued in OH
Practice address
989 Medical Park Dr
Maysville, KY 41056-8750
Phone
(606) 759-3180
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 35065157 OH Primary

Addresses

Primary practice location

989 Medical Park Dr
Maysville, KY 41056-8750

Mailing address

8337 Wycliffe Dr
Cincinnati, OH 45244-2597
Phone (513) 272-1958

Other identifiers 1

IdentifierTypeStateIssuer
0928447MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35065157OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Emergency Physicians Ohio LLC Past Accepting new patients
Indiana Emergency Professionals PC Past Accepting new patients
Artesian Waters Emergency Physicians Past Accepting new patients
Scottsburg Emergency Services, LLC Past Accepting new patients
Preferred Emergency Specialists, Inc. Past Accepting new patients
Preferred Emergency Specialists, LLC Past Accepting new patients
Gardner Street Emergency Physicians Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780624932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8337 WYCLIFFE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452442597",
            "telephone_number": "513-272-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 MEDICAL PARK DR",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410568750",
            "telephone_number": "606-759-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "GARY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35065157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0928447",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.