GRACE PRIMARY CARE PLLC
NPI 1679058804
Nurse Practitioner - Family in Crestwood, KY
About Grace Primary Care Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRACE PRIMARY CARE PLLC (NPI 1679058804) is a healthcare organization registered as a family in Crestwood, Kentucky and active in the NPI registry since October 2018. The organization holds a CLIA Waiver certificate valid through August 1, 2027, maintains a secondary practice location in Crestwood, and lists Renu B George, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Grace Primary Care Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Grace Primary Care PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 18D0320395
Grace Primary Care, PLLC · Crestwood, KYFrequently 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 Grace Primary Care PLLC's NPI number?
The NPI number for Grace Primary Care PLLC is 1679058804. It was assigned to this organization in the NPPES registry on October 3, 2018.
Where is Grace Primary Care PLLC located?
Grace Primary Care PLLC is located at 6520 W Highway 22, Crestwood, KY 40014. The listed phone number is (502) 241-8488.
What is Grace Primary Care PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Grace Primary Care PLLC enrolled in Medicare?
Yes. Grace Primary Care PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Grace Primary Care PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Grace Primary Care PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6) and Family Practice (1). Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Grace Primary Care PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 18D0320395) is associated with this NPI, valid through August 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Grace Primary Care PLLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Grace Primary Care PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Grace Primary Care PLLC was last updated on June 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Grace Primary Care Pllc · NPI 1679058804
Family organization in Crestwood, Kentucky. Organization record, active in the CMS NPPES registry since October 3, 2018.
## Identity
- **NPI:** 1679058804 (Entity type: Organization)
- **Enumerated:** October 3, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Renu George, OWNER
## Practice location
- **Address:** 6520 W HIGHWAY 22, Crestwood, KY 40014
- **Phone:** (502) 241-8488
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Family Practice (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 11, 2019
- **Other identifiers:** Medicaid 7100321490 (KY)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1679058804) · Data from the CMS NPPES public registry.