Grayson Health Park

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

TC494 Issued in KY

Legal business name

GRAYSON HEALTH PARK

Practice address

2020 W Hearthstone CT
Ashland, KY 41102-9445

Phone

(606) 923-2819

NPI assigned

Aug 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Sanjiv Gupta, M.D.NPI 1487761243

Title

Physician

Phone

(606) 474-2200

Specialties & licenses 1

Addresses

Other names 1

• TriState Primary Care Other name

Tax ID family

Sanjiv Gupta MD PSC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sanjiv Gupta M.D. P.S.C.

  • Family Medicine Physician
  • Ashland, KY
  • NPI 1396911327
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sanjiv Gupta, MD

  • Internal Medicine Physician
  • Grayson, KY
  • NPI 1487761243
  NPD (past) Authorized official

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1992258305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W HEARTHSTONE CT",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411029445",
            "telephone_number": "606-923-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W HEARTHSTONE CT",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411029445",
            "telephone_number": "606-923-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYSON HEALTH PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SANJIV",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "606-474-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "TC494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TriState Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tyler Grant, D.O.
• Cristopher Gravelin
• Craigan Gray, MD
• Paul Edward Gray, DMD
• Todd Gray
• Kimberly R Green, FNP
• Rebekah Green
• Emily Kirsten Greene, PA-C
• Greenup County Health Department
• Amy Beth Greer

• Primary Care Clinic/Center in Ashland, KY
• Providers in Ashland, KY by specialty
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.