Graybridge Health, NFP

Primary specialty

Meals ProviderTaxonomy code 174200000X

Legal business name

GRAYBRIDGE HEALTH, NFP

Practice address

520 E Lincoln Ave
Libertyville, IL 60048-2923

Phone

(224) 360-7103

NPI assigned

Nov 28, 2022

Last updated

Nov 28, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth J Grayer Jr., CEONPI 1740884279

Title

Ceo

Phone

(224) 360-7103

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth J Grayer Jr.

  • Driver
  • Libertyville, IL
  • NPI 1740884279
  NPD Authorized official

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1811607138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E LINCOLN AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482923",
            "telephone_number": "224-360-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E LINCOLN AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482923",
            "telephone_number": "224-360-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYBRIDGE HEALTH, NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "GRAYER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "224-360-7103",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.graybridgehealth.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "520 E Lincoln Ave",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600482923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Meals Provider in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Meals Provider in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.