EDWARD ALLAN GRIMBALL (NPI# 1144211541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144211541 |
| Entity Type | Individual |
| Full Name | EDWARD ALLAN GRIMBALL |
| Credential | MD |
| Practice Address |
402 Bogle St Ste 3 Somerset KY 42503-2870 |
| Practice Telephone | 6064519953 |
| Practice Fax Number | 6064511533 |
| Mailing Telephone | 6064519953 |
| Mailing Fax Number | 6064511533 |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2015-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 29702 | KY | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 29702 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM | 000000075035 | 01 |
| KY | 64297021 | 05 | |
| KY | MEDICARE RAILROAD | 1101698818 | 01 |
| KY | CCN/AETNA | 5169150 | 01 |
| KY | ANTHEM | 37J8 | 01 |
| KY | FEDERAL TAX ID | 611350780 | 01 |
| KY | UNITED HEALTHCARE | 04-906 | 01 |
| KY | CHA | 1181211 | 01 |
| Street Address |
402 BOGLE ST STE 3 |
| City | SOMERSET |
| State | KY |
| Zip Code | 42503-2870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932192028 | Donna Sue Nall | Obstetrics & Gynecology | 402 Bogle St, Suite #1, Somerset, KY 42503-2870 | 2005-08-24 |
| 1487079380 | Womens Care of Somerset Corp | Specialist | 402 Bogle St, Suite 2, Somerset, KY 42503-2870 | 2014-02-28 |
| 1679861314 | Womens Care of Somerset Corp | Obstetrics & Gynecology | 402 Bogle St, Suite 2, Somerset, KY 42503-2870 | 2011-07-15 |
| 1861536781 | Donna S. Nall, Md, Psc | Obstetrics & Gynecology | 402 Bogle St, Ste #1, Somerset, KY 42503-2870 | 2007-02-16 |
| 1366539223 | Eadens-grimball Internal Medicine Associates | Nurse Practitioner | 402 Bogle St, Ste 3, Somerset, KY 42503-2870 | 2006-10-10 |
| 1497840680 | Tara R Horn | Obstetrics & Gynecology | 402 Bogle St, Suite 2, Somerset, KY 42503-2870 | 2006-10-04 |
| 1982703617 | Southeast Kentucky Clinic | Specialist | 402 Bogle St, Suite 2, Somerset, KY 42503-2870 | 2006-09-21 |
| 1699878199 | Somerset Cardiology | Nurse Practitioner | 402 Bogle St, Suite 2, Somerset, KY 42503-2870 | 2006-09-07 |
| 1265546139 | Somerset Cardiology | Specialist | 402 Bogle St, Suite 2, Somerset, KY 42503-2870 | 2006-08-18 |
| 1558322503 | Kevin Thomas Kavanagh | Otolaryngology | 402 Bogle St, Ste 310, Somerset, KY 42503 | 2006-03-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023669652 | Carehere LLC | Family Medicine | Carehere Clinic- Toyotetsu Somerset Ky, 80 Pin Oak, Somerset, KY 42503 | 2019-09-25 |
| 1841859766 | Armina Jo Hoeck | Behavior Technician | Kid Spot Center, 200 Tower Circle, Somerset, KY 42503 | 2019-06-13 |
| 1548723042 | Lisa Hunter | Counselor | 225 Ky 2227, Somerset, KY 42503 | 2019-04-11 |
| 1982171237 | Bluegrass Hearing Clinic, LLC | Audiologist | 25 Medpark West, Suite 2, Somerset, KY 42503 | 2018-10-25 |
| 1780109116 | Kentucky Diagnostic Ultrasound, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 324 Water Cliff Dr., Somerset, KY 42503 | 2017-08-07 |
| 1689115172 | Lake Cumberland Physician Practices LLC | Internal Medicine | 154 Bogle Office Park Dr Ste B, Somerset, KY 42503 | 2017-03-16 |
| 1811356892 | Lake Cumberland Physician Practices, LLC | Nurse Practitioner | 27 Imaging Dr, Suite B, Somerset, KY 42503 | 2016-02-18 |
| 1730586447 | Amy Molen | Counselor | 259 Parkers Mill Road, Somerset, KY 42503 | 2014-11-24 |
| 1841630654 | Eastern Pulaski Rural Health Clinic,pllc | Clinic/Center | 31 Mark Shopville Rd, Somerset, KY 42503 | 2013-06-26 |
| 1881978807 | Nathan S Fisher | Counselor | 600 Clifty St Ste 2, Somerset, KY 42503 | 2011-10-10 |
| Find all providers in zip 42503 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
| 1376101055 | Franklin Internists Pa | Internal Medicine | 15 Wexford Way, Somerset, NJ 08873-4880 | 2019-05-29 |
| 1033682729 | Lauren Wadams | Internal Medicine | 75 Veronica Ave Ste 204, Somerset, NJ 08873-5002 | 2019-01-07 |
| 1659759850 | Mohammed Abuzar Khan | Internal Medicine | 225 S Center Avenue Somerset Hospital, Somerset, PA 15501 | 2015-05-08 |
| 1609125467 | Gerard Alphonse Weigel | Internal Medicine | 116 Hillandale Dr, Somerset, KY 42501-1904 | 2012-09-07 |
| 1245587922 | Robert Wood Johnson Physician Enterprise | Internal Medicine | 3 Executive Drive, Suite 400, Somerset, NJ 08873 | 2012-08-13 |
| 1801164074 | Tamanna Yussouf Salim | Internal Medicine | 17 Lenape Dr, Somerset, NJ 08873-4647 | 2011-12-02 |
| 1891081725 | Joseph Nakda | Internal Medicine | 67 Slades Ferry Ave, Somerset, MA 02726-1220 | 2011-06-20 |
| 1194036483 | Mahmoud El Banna | Internal Medicine | 1323 State Route 27, Somerset, NJ 08873-3457 | 2010-07-01 |
| 1891006359 | Tony K George | Internal Medicine | 33 Clyde Rd 105-106, Somerset, NJ 08873-5032 | 2010-06-29 |
| 1295046142 | Franklin Medical Group PC | Internal Medicine | 454 Elizabeth Avenue, Suite 210, Somerset, NJ 08873 | 2010-06-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.