Liesel C Grentz, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

03238 Issued in KY

Practice address

124 Dowell Rd
Russell Springs, KY 42642-4278

Phone

(270) 866-2440

Fax

(270) 866-2442

NPI assigned

Feb 8, 2008

Last updated

May 24, 2019By the provider in NPPES

Sex

Female

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 1

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

Family Practice

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Russell County HospitalGroup PAC ID 6204887243, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lifeline Health Care of Pulaski Home health agency, Somerset, KY, CCN 187099
• Russell County Hospital Hospital, Russell Springs, KY, CCN 181330
• Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: liesel.grentz@crch.eclinicaldirectplus.com

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.

• Russell County Hospital

  • Certified Registered Nurse Anesthetist
  • Russell Springs, KY
  • NPI 1437245842
  Medicare reassignment Care Compare group NPD
• Russell County Hospital

  dba Primary Care Associates of Russell County

  • Rural Health Clinic/Center
  • Russell Springs, KY
  • NPI 1295245025
  NPD
• Russell County Hospital

  • Nurse Practitioner
  • Russell Springs, KY
  • NPI 1538255948

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lake Cumberland Regional Hospital LLC

  dba Lake Cumberland Regional Hospital

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  Care Compare affiliation
• Lifeline Home Health Care of Somerset, LLC

  dba Lifeline Health Care of Pulaski

  • Home Health Agency
  • Somerset, KY
  • NPI 1114951993
  Care Compare affiliation
• Russell County Hospital

  • Critical Access Hospital
  • Russell Springs, KY
  • NPI 1013954437
  Care Compare affiliation

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1821276130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 DOWELL RD",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424278",
            "telephone_number": "270-866-2440",
            "fax_number": "270-866-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 DOWELL RD",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424278",
            "telephone_number": "270-866-2440",
            "fax_number": "270-866-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENTZ",
        "first_name": "LIESEL",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-08",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "03238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100046590",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Freedom Management (S.P.a.R.C.)
• Miles Kenton Gibson, M.D.
• Laura A Godby, LPCC
• Lisa Annette Goodlett, R.PH
• Angela Denise Gossage, PHARM.D.
• Grider Drug LLC
• Eric B Grider
• Jonathan Grider, PHARMD
• Robert Brian Grippe, DMD
• H&H Taxi, LLC (H&H Taxi)

• Family Medicine Physician in Russell Springs, KY
• Providers in Russell Springs, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.