NPIMap

Individual provider Active NPI

Werner Grentz, DO

  • Family Medicine Physician
  • London, KY
National Provider Identifier
1801842653
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02269 Issued in KY
Practice address
106 Nami PLZ Ste 2
London, KY 40741-3125
Phone
(606) 864-0254
Fax
(606) 864-0259
NPI assigned
May 25, 2006
Last updated
Jun 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02269 KY
Family Medicine Physician 207Q00000X 02269 KY Primary

Addresses

Primary practice location

106 Nami PLZ Ste 2
London, KY 40741-3125

Mailing address

2197 Pine Hill Brock Rd
London, KY 40741-8502
Phone (606) 877-1840

Other identifiers 2

IdentifierTypeStateIssuer
3319534MedicaidTN
64022692MedicaidKY

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 Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
02269KYMDFamily Medicine Physician
1684TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC Past Accepting new patients
Rockcastle County Hospital, Inc. Past Accepting new patients
Kentucky River HBP LLC Past Accepting new patients
Memorial Hospital Inc. Family Medicine Past Accepting new patients
Pine Mountain Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Cumberland Clinic, PLLC Past Accepting new patients
Jackson Hospital Corporation Emergency Medicine Past Accepting new patients
Steven D. Spady Past Accepting new patients
Marshall Emergency Services Associates, PLLC Emergency Medicine Past Accepting new patients

Organizations & group practices 10

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1801842653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2197 PINE HILL BROCK RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407418502",
            "telephone_number": "606-877-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 NAMI PLZ STE 2",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407413125",
            "telephone_number": "606-864-0254",
            "fax_number": "606-864-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENTZ",
        "first_name": "WERNER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "02269",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "02269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3319534",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64022692",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.