EDWARD ALLAN GRIMBALL MD
NPI 1144211541
Internal Medicine in Somerset, KY

Active since November 03, 2005PECOS EnrolledAccepts Medicare Assignment
46.65/100
CMS Quality Rating
402 BOGLE ST, STE 3, SOMERSET, KY 42503(606) 451-9953(606) 451-1533 Get Directions Write a Review

NPPES record last updated: April 9, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Edward Allan Grimball Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARD ALLAN GRIMBALL MD (NPI 1144211541) is an individual internal medicine provider in Somerset, Kentucky, licensed in Kentucky (29702) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Lake Cumberland Regional Hospital, and is a graduate of Medical University Of South Carolina College Of Medicine.

NPPES Registry Identity

NPI1144211541
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameEDWARD ALLAN GRIMBALLCredential: MD
Location Address402 BOGLE ST, STE 3Somerset, KY 42503-2870
Mailing Address402 Bogle St, Ste 3Somerset, KY 42503-2870 · (606) 451-9953 · Fax (606) 451-1533
Fax(606) 451-1533
Sole ProprietorNo
Medical School CMSMedical University Of South Carolina College Of Medicine
Enumeration DateNovember 3, 2005
Last NPPES UpdateApril 9, 2015
NPI 1144211541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in KY · 29702
Definition
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.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 29702 (KY)
402 BOGLE ST, Somerset, KY 42503

Other Identifiers 10

Medicare UPINF67443KY
Other1101698818KY · Medicare Railroad
Other37J8KY · Anthem
Other611350780KY · Federal Tax Id
Medicare ID-Type Unspecified0620801KY
Medicaid64297021KY
Other1181211KY · Cha
Other04-906KY · United Healthcare
Other5169150KY · Ccn/aetna
Other000000075035KY · Anthem

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Edward Allan Grimball Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082626429
PECOS Enrollment IDI20060629000009
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
359 services329 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
250 services224 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
180 services173 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
62 services62 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
29 services28 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lake Cumberland Regional Hospital

Acute Care Hospitals · Somerset, KY
2/5 CMS rating
OwnershipProprietary
CMS Certification Number180132
Location305 Langdon StreetSomerset, KY 42503 · Pulaski County
Emergency services Birthing friendly

Knox County Hospital

Critical Access Hospitals · Barbourville, KY
OwnershipGovernment - Local
CMS Certification Number181328
Location80 Hospital DriveBarbourville, KY 40906 · Knox County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

46.65/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality30
Improvement Activities40
Cost19.34

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier19 claims19 services$7.40 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist
402 BOGLE ST, SUITE 2
SOMERSET, KY 42503
Internal Medicine
402 BOGLE ST, STE 3
SOMERSET, KY 42503
Internal Medicine
402 BOGLE ST, STE 3
SOMERSET, KY 42503
Specialist
402 BOGLE ST, SUITE 2
SOMERSET, KY 42503
Obstetrics & Gynecology
402 BOGLE ST, SUITE 2
SOMERSET, KY 42503
Otolaryngology
402 BOGLE ST, STE 310
SOMERSET, KY 42503
Obstetrics & Gynecology (Gynecology)
402 BOGLE ST, SUITE 2
SOMERSET, KY 42503
Nurse Practitioner
402 BOGLE ST, SUITE 2
SOMERSET, KY 42503

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Grimball's NPI number?

The NPI number for Edward Grimball is 1144211541. It was assigned to this individual provider in the NPPES registry on November 3, 2005.

Where is Edward Grimball located?

Edward Grimball practices at 402 Bogle St Ste 3, Somerset, KY 42503. The listed phone number is (606) 451-9953.

What is Edward Grimball's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Edward Grimball enrolled in Medicare?

Yes. Edward Grimball is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Edward Grimball affiliated with any hospitals?

According to CMS data, Edward Grimball is affiliated with Lake Cumberland Regional Hospital and Knox County Hospital.

When was this NPI record last updated?

The NPPES record for Edward Grimball was last updated on April 9, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.