Edward A J Grimball (NPI# 1144211541, PAC ID# 4082626429) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1144211541 |
| PAC ID by PECOS | 4082626429 |
| Professional Enrollment ID | I20060629000009 |
| Full Name | Edward A J Grimball |
| Organization Legal Name | SOUTHEASTERN EMERGENCY PHYSICIANS LLC |
| Address |
305 Langdon St Somerset KY 42503-2750 |
| Phone Number | 6066783110 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 2466364997 |
| Number of Group Practice Members | 226 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180132 | LAKE CUMBERLAND REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 305 Langdon St, Somerset, KY 42503-2750 | 6066783110 | SOUTHEASTERN EMERGENCY PHYSICIANS LLC |
| Organization Legal Name | SOUTHEASTERN EMERGENCY PHYSICIANS LLC |
| Physicians | 252 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Mayer Romain Khafi | Emergency Medicine | Southeastern Emergency Physicians LLC | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 |
| Thomas C Damhoff | Emergency Medicine | Southeastern Emergency Physicians LLC | 727 Hospital Dr, Shelbyville, KY 40065-1660 |
| Daren William Cox | Emergency Medicine | Southeastern Emergency Physicians LLC | 990 Oak Ridge Turnpike, Oak Ridge, TN 37830-6976 |
| Andrew Hunter Wheeler | Emergency Medicine | Southeastern Emergency Physicians LLC | 456 Burnley Rd, Scottsville, KY 42164-6355 |
| Mary E Harkleroad | Family Medicine | Southeastern Emergency Physicians LLC | 1 Trillium Way, Corbin, KY 40701-8420 |
| Lamin Bangura | Family Medicine | Southeastern Emergency Physicians LLC | 1080 Ellington Pkwy, Lewisburg, TN 37091-2227 |
| William J Mcintyre | Emergency Medicine | Southeastern Emergency Physicians LLC | 55 Foundation Dr, Flemingsburg, KY 41041-9815 |
| Robert A Hill | Family Medicine | Southeastern Emergency Physicians LLC | 1260 University Ave, Sewanee, TN 37375-2303 |
| Shirley K Catron | Family Medicine | Southeastern Emergency Physicians LLC | 723 Old Burkesville Rd, Albany, KY 42602-1654 |
| James L Fritzsche | Emergency Medicine | Southeastern Emergency Physicians LLC | 9352 Park W Blvd, Knoxville, TN 37923-4325 |
| Street Address |
305 LANGDON ST |
| City | SOMERSET |
| State | KY |
| Zip | 42503-2750 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory S. Kottkamp | Anesthesiology | Cumberland Anesthesia Associates, Inc. | 305 Langdon St, Somerset, KY 42503-2750 |
| Michael E Helm | Physician Assistant | Apogee Medical Group Kentucky Psc | 305 Langdon St, Somerset, KY 42503-2750 |
| Rainer Oliver | Emergency Medicine | Southeastern Emergency Physicians LLC | 305 Langdon St, Somerset, KY 42503-2750 |
| Justin Timothy Pate | Certified Registered Nurse Anesthetist (crna) | Cumberland Anesthesia Associates, Inc. | 305 Langdon St, Somerset, KY 42503-2750 |
| Dannette S Cook | Hospitalist | Apogee Medical Group Kentucky Psc | 305 Langdon St, Somerset, KY 42503-2750 |
| Brian H Gaskins | Nurse Practitioner | Southeastern Emergency Services P C | 305 Langdon St, Somerset, KY 42503-2750 |
| Krishna Syamala | Family Medicine | Apogee Medical Group Kentucky Psc | 305 Langdon St, Somerset, KY 42503-2750 |
| Jennifer M. Smith | Diagnostic Radiology | Bluegrass Radiology Associates Inc | 305 Langdon St, Somerset, KY 42503-2750 |
| Christopher D Bonn | Emergency Medicine | Southeastern Emergency Physicians LLC | 305 Langdon St, Somerset, KY 42503-2750 |
| Andrew Blakley | Hospitalist | Apogee Medical Group Kentucky Psc | 305 Langdon St, Somerset, KY 42503-2750 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Don L Richardson | Optometry | 246 Poplar Ave, Suite 1, Somerset, KY 42503-1701 | |
| Kenneth E Ruby | Urology | Lake Cumberland Physician Practices LLC | 30 Medpark Square Dr, Suite 1, Somerset, KY 42503-1709 |
| Heidi Renae Frey | Nurse Practitioner | Lake Cumberland Physician Practices LLC | 30 Medpark Square Dr, Suite 1, Somerset, KY 42503-1709 |
| Donna Birney | Clinical Social Worker | Quest Counseling | 600 Clifty St, Suite 2, Somerset, KY 42503-1710 |
| Kelli N Jordan | Clinical Social Worker | Quest Counseling | 600 Clifty St, Suite 2, Somerset, KY 42503-1710 |
| Eric D Johnson | Diagnostic Radiology | 607 Clifty St, Somerset, KY 42503-1765 | |
| Joseph G Weigel | Internal Medicine | Lake Cumberland Regional Hospital LLC | 350 Hospital Way, Suite 100, Somerset, KY 42503-1873 |
| Lisa E Marcum | Nurse Practitioner | Lake Cumberland Regional Hospital LLC | 350 Hospital Way, Suite 100, Somerset, KY 42503-1873 |
| Randall Elliot Dalton | Otolaryngology | Lake Cumberland Regional Hospital LLC | 350 Hospital Way, Suite 100, Somerset, KY 42503-1873 |
| Julie K Stevens | Nurse Practitioner | Lake Cumberland Regional Hospital LLC | 350 Hospital Way, Suite 100, Somerset, KY 42503-1873 |
| Find all physicians in zip 42503 | |||
| City | SOMERSET |
| Zip Code | 42503 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | SOMERSET + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Edward A J Grimball.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.