JACQUELINE GRANESE (NPI# 1649479460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649479460 |
| Entity Type | Individual |
| Full Name | JACQUELINE GRANESE |
| Credential | M.D. |
| Practice Address |
1065 Ashley St Ste 200 Bowling Green KY 42103-3401 |
| Mailing Address |
201 Park St Bowling Green KY 42101-1759 |
| Practice Telephone | 2708433376 |
| Practice Fax Number | 2707800496 |
| Mailing Telephone | (270) 781-5111 |
| Mailing Fax Number | 2708433376 |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2017-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
42560 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100072860 | 05 |
| Street Address |
1065 ASHLEY ST STE 200 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42103-3401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467947267 | Sherelen Hodges | Nurse Practitioner | 1065 Ashley St Ste 200, Bowling Green, KY 42103 | 2018-06-25 |
| 1871083030 | Amber Lynn Riley | Nurse Practitioner | 1065 Ashley St Ste 200, Bowling Green, KY 42103 | 2018-05-14 |
| 1003311036 | Leslie Pemberton | Physician Assistant | 1065 Ashley St Ste 200, Bowling Green, KY 42103-3401 | 2018-03-30 |
| 1184062481 | Juliana Elyse Gilbert | Dermatology | 1065 Ashley St Ste 200, Bowling Green, KY 42103-3401 | 2013-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679127781 | Kw Consulting, LLC | Counselor | 1054 Searcy Way, Suite E, Bowling Green, KY 42103 | 2019-07-26 |
| 1063999662 | Southern Kentucky Surgicenter, LLC | Clinic/Center | 484 Golden Autumn Way, Suite 100, Bowling Green, KY 42103 | 2018-07-26 |
| 1780170936 | Midsouth Psychological Services, LLC | Psychologist | 996 Wilkinson Trce Ste A8, Bowling Green, KY 42103 | 2018-07-10 |
| 1760976146 | Prorehab Inc | Clinic/Center | 1110 Wilkinson Trce Ste 101, Bowling Green, KY 42103 | 2018-06-19 |
| 1063927671 | James Toney | Counselor | 624 Eastwood St, Bowling Green, KY 42103 | 2017-12-05 |
| 1366979528 | Laura Elizabeth Compton | Optometrist | 335 New Towne Drive, Bowling Green, KY 42103 | 2017-05-18 |
| 1033562632 | Elizabette Raby | Massage Therapist | 427 Us-31 Bypass, Suite 203, Bowling Green, KY 42103 | 2016-07-19 |
| 1831572460 | Casey Edward Travelsted | Dentist | 940 Us 31 W Bypass, Bowling Green, KY 42103 | 2015-07-01 |
| 1821435074 | Robert Louis Skaggs II | Dermatology | 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 | 2013-05-29 |
| 1770893257 | Michelle Howell | Health Educator | 261 Moats Lane, Bowling Green, KY 42103 | 2010-10-18 |
| Find all providers in zip 42103 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| 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 Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689927576 | Associate In Dermatology and Dermatopathology Pllc | Dermatology | 1700 Old Bluegrass Ave Ste 200, Louisville, KY 40215-1174 | 2012-10-17 |
| 1386619203 | James Robert Wharton | Dermatology | 13802 Lake Point Cir Ste 102, Louisville, KY 40223-4219 | 2006-02-22 |
| 1023094646 | Vilma C Fabre | Dermatology | 2211 Greene Way, Ste 100, Louisville, KY 40220-4076 | 2005-12-15 |
| 1255851200 | Regional Dermatology Pllc | Dermatology | 989 Governors Ln Ste 220, Lexington, KY 40513-1175 | 2017-06-21 |
| 1023409612 | Dermatopathology Consultants of Kentucky Pllc | Dermatology | 2211 Greene Way, Suite 100, Louisville, KY 40220-4076 | 2015-02-18 |
| 1770781254 | Soon Bahrami | Dermatology | 3810 Springhurst Blvd, Suite 200, Louisville, KY 40241 | 2007-07-06 |
| 1083736557 | Harty Elouise Ashby | Dermatology | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2007-04-04 |
| 1629197397 | Dermatology Associates of Northern Kentucky Psc | Dermatology | 7766 Ewing Blvd, Ste 100, Florence, KY 41042-7538 | 2007-03-27 |
| 1487758983 | Scheen & Smith, P.s.c. | Dermatology | 3950 Kresge Way, Suite 305, Louisville, KY 40207-4637 | 2006-09-13 |
| 1013925106 | Skin Group Pllc | Dermatology | 2211 Greene Way, Ste 100, Louisville, KY 40220-4076 | 2006-08-04 |
| Find all providers with the same taxonomy | ||||
| City | BOWLING GREEN |
| Zip Code | 42103 |
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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.