Sean Timothy Willgruber, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

32326 Issued in KY

Practice address

201 Park St
Bowling Green, KY 42101-1759

Phone

(270) 781-5111

Fax

(270) 783-3779

NPI assigned

Jun 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Diagnostic Radiology

Education

University of Louisville School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

All facility ownership & control disclosures 3

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

Owned or controlled facilities with NPI records 3

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

• Graves Gilbert Clinic PLLC

  • Rural Health Clinic/Center
  • Cave City, KY
  • NPI 1104635663

  Corporate Director

  CMS ownership
• Graves Gilbert Clinic PLLC

  • Rural Health Clinic/Center
  • Brownsville, KY
  • NPI 1285523274

  Corporate Director

  CMS ownership
• Graves Gilbert Clinic, PLLC

  • Rural Health Clinic/Center
  • Munfordville, KY
  • NPI 1922895218

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Graves Gilbert Clinic PLLC

  • Specialist
  • Bowling Green, KY
  • NPI 1114948288
  Medicare reassignment Care Compare group NPD
• Graves Gilbert Clinic PLLC

  • Rural Health Clinic/Center
  • Cave City, KY
  • NPI 1104635663
  NPD
• University Physicians Group - Radiology

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1619061116
  NPD (past)
• University Radiological Associates, PSC

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1528008166
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1790781649",
    "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": "270-783-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-781-5111",
            "fax_number": "270-783-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLGRUBER",
        "first_name": "SEAN",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "32326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5151643",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000191881",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64323264",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Wade Wilkey, D.C.
• Edmund L Wilkins, M.D.
• Lisa Wilkins, LCSW
• Bonny Willard, APRN
• Jessica Marie Willetts
• William a. Schwank, M.D.
• William J. Hanshaw, LMFT
• Alexander Williams
• Christopher Williams, LPCC
• Jennifer Dawn Williams, CSW

• Diagnostic Radiology Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Diagnostic Radiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.