Bernard Dean Grose II, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

01522 Issued in WV

Practice address

12 Kanawha Ter
Saint Albans, WV 25177-2750

Phone

(304) 201-1130

Fax

(304) 201-1134

NPI assigned

Nov 17, 2010

Last updated

Jul 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WV

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Womencare IncGroup PAC ID 4587568134, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bernard.grose.1@7363.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/7363/brand/1/csg/1/fhir/r4

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.

• Womencare Inc

  dba FamilyCare Health Center

  • Federally Qualified Health Center (FQHC)
  • Cross Lanes, WV
  • NPI 1396237434
  Medicare reassignment Care Compare group NPD
• Womencare Inc

  dba FamilyCare Health Center

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1316228166
  NPD
• Womencare Inc

  dba FamilyCare HealthCenter

  • Federally Qualified Health Center (FQHC)
  • Barboursville, WV
  • NPI 1447618327
  NPD
• Womencare Inc

  dba FamilyCare

  • Federally Qualified Health Center (FQHC)
  • Winfield, WV
  • NPI 1477834216
  NPD
• Womencare Inc

  dba Familycare Health Center

  • Federally Qualified Health Center (FQHC)
  • Dunbar, WV
  • NPI 1578073706
  NPD
• Womencare Inc

  dba Familycare Health Centers

  • Federally Qualified Health Center (FQHC)
  • Marmet, WV
  • NPI 1730671751
  NPD
• Womencare Inc

  dba FamilyCare

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1770745036
  NPD
• Womencare Inc

  dba FamilyCare

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1790276525
  NPD
• Womencare Inc

  dba FamilyCare Health Center

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1871872184
  NPD
• Womencare Inc

  dba Familycare Health Center

  • Federally Qualified Health Center (FQHC)
  • Saint Albans, WV
  • NPI 1902166945
  NPD
• Womencare Inc

  dba FamilyCare Health Center - Hurricane

  • Federally Qualified Health Center (FQHC)
  • Hurricane, WV
  • NPI 1962045948
  NPD
• Womencare, Inc

  • Federally Qualified Health Center (FQHC)
  • Eleanor, WV
  • NPI 1255660056
  NPD

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1790087187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 KANAWHA TER",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772750",
            "telephone_number": "304-201-1130",
            "fax_number": "304-201-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 KANAWHA TER",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772750",
            "telephone_number": "304-201-1130",
            "fax_number": "304-201-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSE",
        "first_name": "BERNARD",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-17",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790087187",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV1245B",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019933",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WV1245C",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greenbrier Valley Physical Therapy LLC (Teays Physical Therapy Center)
• Karle Edward Griffith
• Loretta Griffith
• Thomas E Griffith
• Brittany Jeanne Grimmett
• George Grover, LPC
• Kelly Guta
• Andrew Hadley, PHARMD
• Charles Ray Hager, PRSS
• Logan Richard Hall

• Physician Assistant in Saint Albans, WV
• Providers in Saint Albans, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.